Determine whether the District claimed all Medicaid reimbursements to which it was entitled for services provided to eligible special education students.
- The District lacked adequate policies and procedures to ensure Medicaid claims were submitted and reimbursed for all eligible services provided.
- Claims were not submitted and reimbursed for 312 eligible services totaling $11,896 and service providers (providers) did not document 948 scheduled services totaling $69,324 in the special education system (system) as provided. Had these services been appropriately documented and claimed, the District could have realized potential revenues totaling $40,610.
- Service records were not available for 10 students. As a result, we could not determine whether the District submitted all eligible claims for these students.
- Establish adequate policies and procedures for Medicaid reimbursement.
- Review all unclaimed services and submit any eligible claims for reimbursement.
- Ensure providers document all service encounters in the system.
District officials generally agreed with our recommendations and indicated they planned to initiate corrective action.