Edwards-Knox Central School District – Medicaid Reimbursements (2021M-92)

Issued Date
August 20, 2021

[read complete report - pdf]

Audit Objective

Determine whether the Edwards-Knox Central School District (District) claimed all Medicaid reimbursements to which it was entitled.

Key Findings

The District did not claim any Medicaid reimbursements to which it was entitled. District officials:

  • Did not claim Medicaid reimbursements for the 12 students we identified who were likely Medicaid-eligible and received speech, occupational or physical therapy services during 2019-20. Had these services been claimed, the District could have realized revenue totaling about $25,000.
  • Believed it was not cost-effective to file Medicaid claims but could not support their assertions because the District did not prepare a recent cost benefit analysis to support it is not cost-effective.
  • Did not establish Medicaid claim policies or procedures or ensure that sufficient documentation was maintained for the eligible services provided.

Key Recommendations

  • Prepare a Medicaid claiming cost benefit analysis.
  • Establish written Medicaid claim procedures and ensure all Medicaid claim documentation requirements are met.

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