Determine whether the Babylon Union Free School District (District) claimed Medicaid reimbursements for all eligible Medicaid services provided.
The District did not claim any Medicaid reimbursements to which it was entitled, because District officials believed it was not cost-effective to file Medicaid claims. However, they could not provide a current cost-benefit analysis to support their position. As a result, District taxpayers incurred the full cost of providing more than $536,000 in Medicaid-eligible services. Had these services been claimed, the District could have realized potential reimbursements, totaling $268,308.
District officials did not:
- Claim any Medicaid reimbursements, totaling $442,841, for 18 Medicaid-eligible students.
- Examine and seek Medicaid reimbursements, totaling $93,774, for 25 students we identified were likely Medicaid-eligible.
- Establish Medicaid claim policies and procedures or ensure that sufficient documentation was maintained for eligible services provided.
- Establish a process to identify all possible Medicaid-eligible students.
- Establish procedures to ensure all Medicaid documentation requirements are met.
- Submit all eligible claims for reimbursement.
District officials generally agreed with our recommendations and have indicated they planned to initiate corrective action.