Kansas is fighting HCFA over an increase in the amount state Medicaid recipients pay per hospital admission.
Kansas raised its Medicaid copayment last year to $325 from $25 despite objections from both HCFA and the Kansas Hospital Association.
HCFA argues that Kansas hasn't shown its copayment increase is in the best interest of Medicaid recipients.
Because regulations limit copayments to 50% of a charge, HCFA also wants Kansas to create copayments for each admission and each provider.
Kansas maintains it has met HCFA regulations. Congress decided copayments were appropriate when it authorized them, argued Reid Stacey, an attorney for the Kansas Department of Social and Rehabilitation Services.
In March, Kansas told the HCFA regional office in Kansas City that it wouldn't suspend the copayment increase while the agency reviewed it. The state still is requiring the higher copayment, even though HCFA's Washington office in July refused to approve the change. Kansas planned to ask HCFA to reconsider its decision last week, Mr. Stacey said.
Meanwhile, a hearing is set for Oct. 7 on the hospital association's second request for a preliminary injunction against the copayment increase. Earlier this month, the 10th U.S. Circuit Court of Appeals in Denver upheld the lower court's initial refusal (Dec. 6, 1993, p. 26) to issue a preliminary injunction. The KHA contends that the higher copayment is, in effect, a rate decrease for its 126 members because Medicaid recipients won't always pay it (Oct. 11, 1993, p. 28).
The higher copayment was expected to cut $2.6 million from the more than $300 million Kansas will spend on medical services in fiscal 1994, which began July 1. Kansas estimates the copayment has saved about $800,000 in state funds and $1.2 million in matching funds, so far.