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NYS Comptroller

THOMAS P. DiNAPOLI

Audits of Local Governments and School Districts

Report Highlights

Ausable Valley Central School District - Medicaid Reimbursements (2018M-189)

Released: January 25, 2019 -- [read complete report - pdf]

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 1,674 eligible services totaling $58,965 and service providers did not document 1,593 scheduled services totaling $54,054 in the special education system (system) as having been provided to students. Had these services been appropriately claimed and documented, the District could have realized potential revenues totaling $56,510.
  • District officials did not submit any claims for reimbursement from 2011-12 through 2014-15 or submit claims for all eligible services provided from 2015-16 through 2017-18 due to inadequate procedures.

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. Appendix B includes our comment on an issue that was raised in the District’s response letter.

Background

The Ausable Valley Central School District (District) serves the residents of the Towns of Ausable, Black Brook and Peru in Clinton County, Chesterfield, Jay, Keene, Willsboro and Wilmington in Essex County and Franklin in Franklin County.

The seven-member elected Board of Education (Board) is responsible for the general management and control of financial and educational affairs. The Superintendent of Schools is the chief executive officer and, along with other administrative staff, is responsible for day-to-day management under the Board’s direction.

The Director of Special Education (Director) oversees the District’s special education program.

Quick Facts
Enrollment1,155
2016-17 Medicaid Reimbursements$45,699
2017-18 Medicaid Reimbursements$49,327

Audit Period

July 1, 2016 – June 30, 2018. We extended our audit period back to July 1, 2011 to review Medicaid claims submitted and reimbursed.


Local Government and School Accountability Contact Information:

Phone: (518) 474-4037; Email: localgov@osc.ny.gov
Address: Office of the State Comptroller, Division of Local Government and School Accountability
110 State Street, 12th Floor; Albany, NY 12236