NAMPI Member Portal | Kurt Kresta | Activity https://staging.member.nampi.net/members/kkrestadhs-hawaii-gov/activity/ Activity feed for Kurt Kresta. Mon, 20 Oct 2025 17:54:03 -0400 https://buddypress.org/?v=2.9.30 en-US 30 hourly 2 9d3cc7a9c8f2d478cd88f22122176093 Kurt Kresta started the discussion Administrative terminations for criminal acts not involving Medicaid in the forum State Only Forum https://staging.member.nampi.net/nampi-member-forums/discussion/administrative-terminations-for-criminal-acts-not-involving-medicaid/ Wed, 20 Dec 2023 22:42:39 -0500 Administrative terminations for criminal acts not involving Medicaid

Aloha NAMPI colleagues,

In Hawaii we have been challenged by our administrative hearing officers regarding termination of providers for criminal offenses not involving fraud or other Medicaid related offenses. They have ruled that the wording of our administrative rules does not specify we can terminate providers for other criminal offenses.…

Read more

]]> c466eb1754d3c00084f723c0a1731b3c Kurt Kresta replied to the discussion Payment Suspension against 1 provider in group practice in the forum State Only Forum https://staging.member.nampi.net/nampi-member-forums/discussion/payment-suspension-against-1-provider-in-group-practice/#post-1906 Tue, 14 Feb 2023 21:49:44 -0500 Reply to Payment Suspension against 1 provider in group practice

Aloha,

We in Hawaii have had this situation a few times. We have chosen to suspend the payments to any claims with the suspended provider as the servicing provider. However, we recognize that allows the providers to simply bill under the group ID and not list the suspended provider as the servicing provider.

]]> b857a011d00c99eb39592c16ab96c563 Kurt Kresta replied to the discussion Civil case settlements in the forum State Only Forum https://staging.member.nampi.net/nampi-member-forums/discussion/civil-case-settlements/#post-1727 Wed, 17 Aug 2022 18:04:36 -0400 Reply to Civil case settlements

Aloha Dawn,

The amount of the overpayment is returned to the the Medicaid program and the federal share is refunded. Anything above that amount is usually retained by the MFCU as punitive damages. Sorry, I don’t know how it is recorded on CMS 64.

]]> 9e1c7deadd6c5e355714e70cab2a2873 Kurt Kresta replied to the discussion MCO Contracts and Program Integrity in the forum State Only Forum https://staging.member.nampi.net/nampi-member-forums/discussion/mco-contracts-and-program-integrity/#post-1726 Wed, 17 Aug 2022 17:55:29 -0400 Reply to MCO Contracts and Program Integrity

Aloha MayKay, you can find a copy of our contract (called RFP in Hawaii) at this link:

https://medquest.hawaii.gov/content/dam/formsanddocuments/resources/solicitations-and-contract/QI%20RFP-MQD-2021-008%20amend%201-5docx.pdf

Our liquidated damages clauses are in section 14.21.

]]>