The Legislature created the Health Care Access Improvement Program (HCAIP) in 2004 to increase the state’s Medicaid reimbursement rates for health care providers. KDHE combines hospital tax revenues collected under the HCAIP program with federal matching funds to increase reimbursement rates to both hospitals and non-hospital health care providers.  They increase rates through an add-on percentage  For hospitals it is a standard percentage.  For non-hospital providers, the add-on percentage varies by procedure.  Out of 900 procedure codes, the audit showed that 20 procedures generated 74% of total non-hospital Medicaid reimbursements in 2019. The add-on percentages for the procedure codes that generated the most Medicaid reimbursements for non-hospital providers ranged from 4.2% to 110.9%. 
Kansas’ Medicaid system has made it difficult for KDHE to adequately monitor and report HCAIP expenditures and revenues. State statute requires HCAIP revenues to be disbursed in a specific way and that the program be state general fund neutral. In 2020, HCAIP did not comply with those two provisions in state law. It is unlikely that KDHE can ensure compliance without changes to the HCAIP program. Finally, the HCAIP fund report we reviewed does not capture all HCAIP assessment revenues and expenditures.