Center Moriches Union Free School District – Medicaid Reimbursements (2017M-174)

Issued Date
December 22, 2017

Purpose of Audit

The purpose of our audit was to assess the District’s Medicaid reimbursement procedures for the period July 1, 2015 through December 31, 2016.

Background

The Center Moriches Union Free School District is located in the Town of Brookhaven, Suffolk County. The District, which is governed by an elected five-member Board of Education, operates three schools with approximately 1,650 students. Budgeted appropriations the 2016-17 fiscal year totaled approximately $41.2 million.

Key Findings

  • The District did not claim $117,670 in costs for individual education plan (IEP)-related services provided to Medicaid-eligible students because it did not obtain prescriptions, parental consent was not obtained or service providers did not meet certain qualifications for reimbursement or did not provide the proper documentation for claiming reimbursement.
  • The District did not submit claims for reimbursable IEP-related services totaling $74,393 because the services were provided by a therapist who did not have the licensing required to be eligible for Medicaid reimbursement.

Key Recommendations

  • Establish procedures to ensure that all documentation requirements for the claims reimbursement process are met, including parental consents, prescriptions and service encounter details.
  • Ensure that all IEP-related services are provided by, or under the supervision of, a licensed therapist as required for Medicaid reimbursement.