LEAVENWORTH, Kan. (AP) — A Leavenworth physician has been convicted of defrauding the Medicaid program by billing for services he didn’t perform and altering patients’ records.
The attorney general’s office said 71-year-old Adnan Ashkar pleaded no contest Wednesday to six felony counts in Leavenworth County District Court. He will be sentenced Oct. 22.
Ashkar was ordered as part of his plea agreement to immediately pay $12,000 in restitution to Kansas Medicaid program. He will also be barred from future participation in the program.
Prosecutors said the fraud went on from January 2009 to December 2013.
TOPEKA — House Minority Leader Paul Davis, the Democratic candidate for governor, said Tuesday that if elected he would order a “top-to-bottom” review of KanCare.
Republican Gov. Sam Brownback spearheaded KanCare, which places the state’s 400,000 Medicaid recipients under the administration of three private insurance companies, also known as managed care organizations (MCOs).
The governor has said the program is on track to meet its goal of saving the state $1 billion over five years through care coordination without cutting services, eligibility or provider payments.
But health care providers who serve Medicaid recipients have complained of later payments since the switch, and Davis said he’s hearing from nursing homes, hospitals, doctors and home health agencies that are becoming financially strapped.
“It’s causing a lot of cash flow problems for health care agencies across the state, and I think it’s further proof this is just not working very well,” Davis said. “What I want to do when we come into office is really take a top-to-bottom look at the KanCare program.”
The Brownback campaign referred questions to the Kansas Department for Health and Environment, which administers the KanCare contracts for the three managed care companies: Amerigroup, Sunflower State Health Plan and United HealthCare.
Sara Belfry, a spokeswoman for KDHE, said the state is working with the companies to smooth claims processing. But she said some of the problems lie with the health care providers submitting the claims.
“Individual providers continue to struggle with some aspects of their billing,” Belfry said via email. “We are making every effort to assist them. KDHE continues to work with all MCOs on provider payment issues that arise. We believe KanCare is working better and more efficiently for the people it serves than (the) old Medicaid system.”
While some payments are delayed, Belfry said claim denials have been cut in half since fiscal year 2008 and now are around 15 percent.
Meanwhile, Belfry said the Medicaid recipients are seeing health care improvement under KanCare versus the previous state-run fee-for-service plan.
She highlighted $1.6 million in newly covered adult dental care, a more than one-third increase in primary care physician usage between 2012 and 2013, and a 4 percent drop in emergency room utilization in the same time frame. For recipients of home- and community-based services, who were added to KanCare this year, ER visits are down 27 percent, she said.
“The KanCare model encourages consumer-centered care at the right time and right amount with more flexibility to address individual situations than ever existed in Kansas Medicaid before KanCare,” Belfry said.
Davis said he’s “not necessarily against managed care” and that it can work well under some circumstances, but the provider complaints suggest KanCare is “clearly not working very well right now.”
If elected, Davis said his administration would consult with medical providers and Medicaid clients to “find out what’s working and what’s not working.”
Officials from KDHE told legislators that in 2013 none of the three managed care companies met the goals for timely claims payment that the agency set in the contracts the companies signed.
Representatives from the companies, which lost more than $100 million in the program’s first year, have said the state’s goals are aggressive but that they are committed to meeting them.
Belfry said the managed care companies paid 99.98 percent of “clean claims” within a month of receiving them, but the state is shooting for 100 percent.
“All three KanCare contracts require that the MCOs pay providers within 30 days of a clean claim being submitted, and the state is very serious about ensuring providers are paid promptly,” Belfry said.
Davis also said Tuesday that it is important for the state to have an inspector general for the KanCare program, but he questioned whether the current position, housed within KDHE, provided enough independence to act as a proper watchdog.
He also questioned the administration’s previous choice to appoint Rep. Phil Hermanson, who resigned before going through a Senate confirmation hearing.
“Clearly the last person they put forward was not qualified for the job, and I hope we can find somebody for that job who is well-qualified,” Davis said.
Davis said he had no names in mind.
Belfry said KDHE is setting up interviews with candidates for inspector general.
Keen Umbehr, the Libertarian candidate for governor, also has been critical of KanCare.
WASHINGTON (AP) — Democrats may stage a campaign-season Senate vote as early as next week on their effort to increase the federal minimum wage — even though the measure seems doomed to lose again.
They’re also hoping to revisit a pair of other issues this month that like the minimum wage were scuttled earlier this year by Republicans.
One would let people refinance student loans at lower interest rates. The other would pressure employers to pay female workers the same as men.
All three measures seem sure to lose.
But congressional elections in which Republicans hope to capture Senate control are less than eight weeks away. Democrats and their supporters see the issues as a chance to win over working-class, female and younger voters — groups that often back Democratic candidates.
WASHINGTON (AP) — A person briefed on the matter says the Justice Department plans to open an investigation into the practices of the Ferguson, Missouri, Police Department.
The person said the investigation, which follows a police officer’s shooting of an unarmed black man, could be announced as early as Thursday. The official said the investigation will look at the training and practices of the Ferguson department.
The investigation is separate from an ongoing civil rights investigation the Justice Department is conducting into the Aug. 9 shooting of Michael Brown. Local authorities are also investigating the shooting as well.
The person spoke on condition of anonymity because the investigation, first reported by The Washington Post, had not yet been announced.
Billy Mills, in white shirt and khaki pants, walks along the new Kickapoo Diabetes Walking Trail during a dedication event. Others participating in the walk included, front from left, Miss Kickapoo Daryl Hooper, Kickapoo Chairman Steve Cadue and fitness director Lucas Holmes.-Photo by Phil Cauthon
KHI News Service
KICKAPOO RESERVATION — It’s early on a Saturday morning and about 100 people – most of them members of the Kickapoo tribe – are gathering for the dedication of a new walking trail on the reservation, situated on about 20,000 acres in the glacial hills of northeast Kansas near Horton.
On hand to help with the ceremony is an athlete whose name may have faded a bit from public memory, but who still qualifies as a living legend here.
Billy Mills, looking much younger than his 76 years, steps to the microphone and starts to speak. He talks about how the values and spirituality of his Lakota Sioux culture sustained him as he fought to overcome poverty and prejudice on his way to winning an Olympic gold medal. And about his personal struggle with Type 2 diabetes, which wasn’t diagnosed until decades after his improbable victory in the 10,000 meters at the 1964 Tokyo Olympics.
Mills says the media of the day used to attribute his tendency to fade at the end of long races to a lack of character, when low blood sugar was the real cause. He thought about quitting but kept running.
“It’s our virtues and values that give us confidence, that give us direction and clarity of mind to start a project and stay the course,” says Mills, his voice rising with conviction. “I want us all to take the virtues and the values of our culture – and our traditions and spirituality – on our journey to defeat and control diabetes.”
Mills, co-founder of the nonprofit organization Running Strong for American Indian Youth, finishes his remarks and heads toward the new Kickapoo Diabetes Walking Trail to lead an initial group of walkers.
Agreeing to an interview while he walks, Mills says he hopes that his presence helps inspire people “to take control of their health.” But, he says, it’s the inspiration that he draws from people he meets that motivates him to spend Saturdays like this one far from his Sacramento, Calif., home.
“What inspires me is a lady who has lost 100 pounds and asks me to enter a fun run with her,” he says. “I enter the fun run and she beats me. That’s a true story.”
‘Creeping’ into youth
American Indians need all the star power and inspiration they can draw from it to reverse a disease trend that is devastating their communities. American Indian and Alaska Native adults are more than twice as likely as non-Hispanic whites to develop diabetes, according the Centers for Disease Control and Prevention.
But it’s the increasing number of American Indian children being diagnosed with diabetes that is perhaps most alarming. The rate of diabetes among American Indian and Alaska Native youth between 15 and 19 years old has jumped by more than 100 percent since 1990.
“Before, it (diabetes) had been largely with the adults, but now it’s creeping its deadly way into the youth,” says Steve Cadue, the Kickapoo chairman. “It’s terrible. We’re seeing diabetes getting down into the grade school ages.”
The half-mile walking trail and other initiatives, including diabetes management and cooking classes, demonstrate the Kickapoo’s determination to stem the tide. As does Cadue’s directive that gives Kickapoo Nation employees three hours a week to exercise or attend the classes during the workday.
Several of the anti-diabetes initiatives were catalyzed by a multiyear “vulnerable populations” grant from the Centers for Disease Control and Prevention. Administered by the Association of American Indian Physicians (AAIP), the goal of the project, which is entering its fifth and final year, is to help the Kickapoo initiate sustainable programs to combat diabetes.
“I’m definitely seeing a difference,” says DeRoin, an AAIP member and a leader of the project. “It’s sort of like diabetes (awareness) is in the air. There are people who I had not seen as patients until they began to make significant changes who are now coming to me and saying with great pride, ‘This is what I’ve been able to do.’”
Partnerships also have been important to the project, DeRoin says. For several years, AARP Kansas has partnered with AAIP to bring Richard Hetzler – head chef of the Mitsitam Café at the Smithsonian National Museum of the American Indian – to Kansas to help members of four tribes learn how to prepare ancestral dishes using nutritious ingredients.
“AARP has just been a total surprise and a fabulous partner,” DeRoin says. “In November, we’ll hold our fourth annual diabetes cooking class sponsored entirely by AARP Kansas.”
The walking trail project was done in partnership with AAIP and the Sunflower Foundation, which has invested more than $2 million since 2005 in public trails and other building projects that help Kansans to be more physically active.
“It isn’t enough to have a program. You actually have to change the environment in which people live, work and play,” says Sunflower program officer Elizabeth Stewart, explaining the foundation’s commitment to “built environment” projects.
The Kickapoo trail project, she says, grew out of a chance meeting she had at a conference with someone who was working with the tribe on its efforts to curb diabetes.
“We were talking about trails and they said, ‘Gosh, we have no place to walk on our reservation. We have a lot of land but no place safe to walk,’” Stewart recalls. “So we went to work and came up with a plan and were able to partner with them to build this half-mile trail – the first on the reservation.”
Planning already is under way, Stewart says, to expand the trail system.
Dr. Ronnie Bell, an epidemiologist from Wake Forest University, is in charge of evaluating the five-year project. A member of the Lumbee Tribe of North Carolina, Bell says the data so far confirm DeRoin’s observations that progress is being made.
“I think there has been a tremendous amount of change as evidenced by a gathering like this,” Bell said. “In rural communities like this, oftentimes there aren’t resources to support exercise and healthy eating. So I think this is a great sign that people are embracing what’s going on here.”
It’s not reasonable to expect a five-year project to produce a significant reduction in the prevalence of diabetes among the Kickapoo, say Bell, DeRoin and others. What’s important, they say, is whether the tribe has institutionalized the kind of changes in diet, exercise and lifestyle that can lead to better health.
“Our goal for year five is to help the coalition look at all the varieties of ways they can sustain these efforts,” DeRoin says.
‘Seeing a difference’
Dr. Dee Ann DeRoin sees patients every Friday at the Kickapoo Nation Health Center. She says the project has helped people with diabetes and those at risk for the disease to make big changes in diet and lifestyle.
DAKAR, Senegal (AP) — U.S. health officials are warning that the Ebola outbreak in West Africa is likely to spread to more countries.
During a telephone briefing with reporters, Tom Kenyon of the U.S. Centers for Disease Control and Prevention said the disease is spreading faster than health workers can keep up with it. He says the world has the tools to stop the outbreak; they just have to be put in place. Kenyon says more treatment centers are being opened, and that he will be talking with the African Union about sending more health workers.
The World Health Organization says at least $600 million is needed to fight the outbreak, which has now killed more than 1,900 people. The agency says the top priority is providing protective gear to health workers in the affected areas.
Doctors and nurses have been especially vulnerable to Ebola because they work closely with Ebola patients.
The WHO announced today that a doctor in southern Nigeria exposed dozens of people to the Ebola virus by continuing to treat patients after he became ill. He died, and his widow and sister are sick with Ebola. About 60 others in the city of Port Harcourt are under surveillance.
JEFFERSON CITY (AP) – An executive at the Boeing Co. has again been appointed to the state Highways and Transportation Commission by Gov. Jay Nixon.
Bryan Scott was appointed to the panel Wednesday, his second such nomination in less than a year.
Nixon originally appointed Scott to the commission last October but withdrew his nomination when the Senate did not confirm Scott by an early February deadline.
The new appointment means Scott can begin serving on the panel immediately, but he will still be subject to Senate confirmation when the Legislature convenes in January.
Scott is the director of quality for Boeing, where he has worked since 1988. He is a Democrat from St. Louis. His term on the transportation commission would run until March 1, 2017.
TOPEKA, Kan. (AP) — The Democratic candidate in the U.S. Senate race in Kansas had ended his campaign.
Democrat Chad Taylor had been running against three-term Republican incumbent Pat Roberts. Taylor sent a letter Wednesday to the Kansas secretary of state, withdrawing from the race.
The race also has a viable independent candidate, Olathe businessman Greg Orman.
Taylor issued a separate statement saying he made the decision after consulting with his staff, supporters and Democratic Party leaders. He did not give a reason.
He said, “Effective today, my campaign is terminated.”
Taylor is the district attorney in Shawnee County, home of the state capital of Topeka. He won the office in 2008 and was re-elected without opposition in 2012.
COLUMBIA, Mo. (AP) — Gov. Jay Nixon is eliciting support from health professionals as he tries to persuade Missouri lawmakers to sustain his veto of legislation dealing with electronic cigarettes.
Nixon convened a panel of medical doctors and officials from the lung, heart and cancer associations Wednesday to highlight what they described as the dangers of electronic cigarettes.
Legislators are to meet next week to decide whether to override Nixon’s veto of legislation that would prohibit the sale of electronic cigarettes to people younger than 18.
Nixon says he vetoed the bill because it also would prohibit the state from regulating or taxing electronic cigarettes as tobacco products.
Health professionals on Nixon’s panel said e-cigarettes contain nicotine derived from tobacco and can be addictive just like regular cigarettes.
LEAVENWORTH, Kan. (AP) — A Leavenworth physician has been convicted of defrauding the Medicaid program by billing for services he didn’t perform and altering patients’ records.
