ST. REGIS FALLS – A recent audit by the State Comptroller’s Office found that the St. Regis Falls Central School District failed to maximize Medicaid reimbursements for services provided, and the district is working to resolve the issue .
According to the audit, from July 1, 2019 to March 31, 2021, the district did not submit claims for 381 eligible services totaling $ 23,060, which would have resulted in $ 11,530 in revenue.
The Comptroller’s Office said services provided but not submitted and reimbursed included speech therapy, occupational therapy, physiotherapy and psychological counseling. These were provided by district staff, Brushton-Moira Central School District staff, and third-party vendors.
The reasons why the claims were not submitted or reimbursed included that they were not properly documented, were not submitted even though all documentation requirements were met and the claims with errors of submission were not corrected and resubmitted, the audit said.
The auditors recommended that district officials:
• Establish procedures to ensure that all documentation requirements are met to submit Medicaid claims for all eligible services provided.
• Review documentation of reimbursement requests submitted by the Special Education Assistant.
• Reconcile the amounts claimed for Medicaid reimbursement with the amounts received and review all rejected or denied claims to determine if they can be resubmitted.
• Review all unclaimed services identified in the audit report and submit any eligible reimbursement requests.
• Correct and resubmit rejected claims identified in the audit report for reimbursement.
District treasurer Michael Tallman said in a statement that the district takes all of the findings very seriously.
“We have worked with the comptroller’s office to identify these issues, and we are now doing everything we can to ensure that we claim every dollar that can be returned to the district through Medicaid.”
District administrators and the school board audit committee have developed a corrective action plan that includes new policies that establish a timeline for vendors to submit their memos, a regular schedule for the business office to verify repayments and monthly meetings to ensure that the new measure elements of the plan are maintained, according to a press release.
The plan is currently being implemented.
