OIG: New York schools owe repayment of $96 million in transportation claims
Healthcare Auditing Weekly, October 11, 2005
The OIG has determined that the New York City Department of Education (NYCDE) claimed $96 million in prohibited federal Medicaid payments for transportation services. The audit period covered September 1, 1993, through June 30, 2001. None of the 120 transportation claims the OIG audited complied with requirements. Specifically,
for 119 claims, the OIG was unable to verify that billed transportation services were rendered
for 97 claims, a Medicaid-covered school health service other than transportation was not rendered on days when transportation was billed
eight claims lacked documentation altogether
for 33 claims, no child's plan/family plan was provided or the plan was untimely
36 claims did not include a recommendation for transportation services in the child's plan/family plan
The OIG has recommended that the state refund the $96 million and work with CMS to resolve documentation issues for an additional $12 million in claims. To complete the audit, the OIG
reviewed applicable federal and state regulations, and prior survey work
met with appropriate officials to gain an understanding of procedures for billing transportation services to Medicaid
made survey site visits to NYCDE from April 2000 through June 2000
identified claims totaling $245 million (with $122 million in federal money) made by NYCDE
used stratified random sampling techniques to select a sample of 120 claims from the universe of 1 million transportation claims for review
Click here to read the audit report, "Review of Medicaid Transportation Claims Made by the New York City Department of Education," (A-02-03-01023) issued Sept. 15, 2005.
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