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Audit Objective

Determine whether the St. Regis Falls Central 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.

• The District lacked adequate procedures to ensure Medicaid claims were submitted and reimbursed.
• Claims were not submitted for 381 eligible services totaling $23,060. Had these services been claimed, the District would have realized revenues totaling $11,530, 50 percent of the reimbursement.

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 and submit any eligible claims for reimbursement.

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