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Audit Objective

Determine whether the Ogdensburg City School District (District) maximized Medicaid reimbursements by submitting claims for all eligible Medicaid services provided.

Key Findings

The District did not maximize Medicaid reimbursements by submitting claims for all eligible Medicaid services provided.

• Claims were not submitted and reimbursed for 1,365 eligible Medicaid services provided totaling $65,254, which resulted in the District not realizing $32,627 in revenue.
• The District lacked adequate procedures to ensure that Medicaid claims were submitted in a timely manner, necessary documentation requirements were met, and disallowed claims were reviewed and resubmitted when appropriate.

Key Recommendations

• Establish procedures to ensure that all documentation requirements are met to submit Medicaid claims for reimbursement for all eligible services provided.
• Submit reimbursement claims for all eligible unclaimed services.

District officials agreed with our recommendations and indicated they have initiated corrective action.