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Audit Objective

Determine whether the District claimed all Medicaid reimbursements to which it was entitled for services provided to eligible special education students.

Key Findings

• The District lacked adequate procedures to ensure Medicaid claims were submitted and reimbursed for all eligible services provided.
• Claims were not submitted and reimbursed for 517.5 eligible services totaling $21,211 and service providers did not document 1,769.5 scheduled services totaling $56,998 in the special education system (system) as having been provided. Had these services been appropriately claimed and documented, the District could have realized potential revenues totaling $39,105.

Key Recommendations

• Establish procedures to ensure all documentation requirements are met to submit Medicaid claims for reimbursement for all eligible services provided.
• Review all unclaimed services, determine whether these services are reimbursable and submit any eligible claims for reimbursement.
• Ensure service providers document all service encounters in the system.

District officials generally agreed with our recommendations and have initiated, or indicated they planned to initiate corrective action.