Page Index

OIG Audits top

Connecticut

• Review of Rate Setting Methodology Medicaid School-Based Child Health Program Costs Claimed by the Connecticut Department of Social Services July 1997 Through June 2001 (A-01-02-00006)
  

• Review of Medicaid School Based Child Health Service Costs Claimed by Connecticut Department of Social Services October 1999 - September 2000 (A-01-01-00006)

• State September 27, 2002 letter on ongoing federal audit. You need Formatta Filler to read this file.

Illinois

• 1/15/2004 HHS OIG Report:Review of Illinois Medicaid School-Based Services for the Period July 1, 2000 through June 30, 2001

Iowa

• Audit of the Iowa Department of Human Services' Claim for Medicaid School-Based Administrative Costs (A-07-02-02099)

Florida

• Review of Administrative Costs Claimed by the Florida Medicaid Agency for School-Based Health Services, A-04-00-0216

Maryland

• Review of Medicaid School-Based Services Claimed During State Fiscal Year 2000 by Maryland's Medicaid Program (A-03-01-00224)
• Maryland Department of Health and Mental Hygiene Docket No. A-05-96 Decision No. 2090 DATE: June 11, 2007

   

   

   

Massachusetts

• Friday, August 8, 2003 - OIG Releases "Medicaid Payments for School-Based Health Services - Massachusetts Division of Medical Assistance - July 1999 Through June 2000 (A-01-02-00009)
  

• Medicaid Payments for School-Based Health Services Boston, Massachusetts - July 1999 Through June 2000 (A-01-02-00001)
  

• Medicaid Payments For School-Based Health Services New Bedford, Massachusetts - July 1999 Through June 2000 (A-01-01-00005)
  

• Medicaid Payments For School-Based Health Services Haverhill, Massachusetts- July 1999 Through June 2000 (A-01-02-00007)
  

• Medicaid Payments For School-Based Health Services Fall River, Massachusetts - July 1999 Through June 2000 (A-01-02-00005)
  

• Medicaid Payments For School-Based Health Services Worcester, Massachusetts- July 1999 Through June 2000," (A-01-01-00008)
  

• Medicaid Payments For School-Based Health Services Holyoke, Massachusetts - July 1999 Through June 2000 (A-01-02-00004)
  

• Medicaid Payments for School-Based Health Services Springfield, Massachusetts -July 1999 Through June 2000," (A-01-02-00003)
  

• Medicaid Payments for School-Based Health Services Lynn, Massachusetts - July 1999 Through June 2000 (A-01-02-00002)

Michigan

• Medicaid mix-up costly. State may be stuck with billing worth $300 million-Link to Detroit Free Press January 2002 Article
  

• Federal Government Approves School Based Services Settlement Agreement-Link to Governor John Engler's Press Release April 15, 2002
  

• MICHIGAN Settlement Agreement with CENTERS FOR MEDICARE & MEDICAID SERVICES, May, 2002. You need Formatta Filler to read this file.

New Jersey

• Review Of Payments For Transportation Services Made To Special Service School Districts Under New Jersey's Medicaid Program (A-02-02-01022)

New York State

• OIG Issues Audit of Upstate NY School Based Transportation - 8/31/2004

• Released March 3, 2004 - Review of Medicaid Speech Claims Made by School Health Providers in New York State (A-02-02-01030)
  

• Office of Inspector General's Partnership Plan - New York State Comptroller Report on Controlling Medicaid Payments for School and Preschool Supportive Health Services, A-02-01-01024 October 5, 2001
  

• Office of Inspector General's Partnership Plan - New York State Comptroller Report on Duplicate Medicaid Payments to School Districts and Counties for School and Preschool Supportive Health Services Claims," (A-02-02-01006) March 4, 2002
  

• Follow-Up Review of a Finding Contained in a New York State Office of the State Comptroller Audit Report on Duplicate School Health Claims to Medicaid Made by the New York City Board of Education (A-02-02-01018)

North Carolina

• Medicaid Monthly Payments for School-Based, Health-Related Services in North Carolina (A-04-00-02161)

Oklahoma

• January 25, 2005 Departmental Appeals Board Denial of CMS's Reconsideration Request.

• 2004.06.14 DAB1924 Oklahoma Health Care Authority Note: On July 3, 2004 CMS requested the Departmental Appeals Board reconsider this decision. Briefing is scheduled to be completed by the end of October and a decision will follow.

• "Audit of Oklahoma Medicaid School-Based Services Provided Free to Other Students and Not Exempt Under the Individuals with Disabilities Education Act," (A-06-01-00077)
  

• "Audit of Medicaid School-Based Services in Oklahoma," (A-06-01-00083) April 11, 2003

Oregon

• Review of Oregon State's Administrative Cost Claimed for Medicaid School-Based Health Services in State Fiscal Year 2000 (A-10-02-00002)
  

• Review of Oregon's Medicaid Payments for School-Based Health Services Direct Care in State Fiscal Year 2000 (A-10-01-00006)
  

• Oregon Attorney General Hardy MYERS ANNOUNCES SETTLEMENT WITH GASTON SCHOOL DISTRICT

Also see Eagle Point

Rhode Island

• 3/9/2004 - Medicaid Payments for School-Based Health Services, Rhode Island, for thePeriod July 1999 Through June 2001 (A-01-02-00014

Texas

• MAXIMIZING FEDERAL REIMBURSEMENT FOR MEDICAID SCHOOL HEALTH AND RELATED SERVICES (SHARS) An examination of the reasons school districts in Texas are not participating or billing for reimbursement from the SHARS program
  

• 02/06/04 HHS OIG Report: Audit of Houston Administrative Costs Claimed for Medicaid School-Based Health Services (A-06-02-00037)
  
  

Washington State

• Review of Washington State's Administrative Costs Claimed for Medicaid School-Based Health Services in State Fiscal Year 2000
  

• Washington State K-12 Education System Single Audit Pilot Project Report September 1, 2000 through August 31, 2001
  

• Review of Washington State's Medical Assistance Costs Claimed for School-Based Health Services Provided in State Fiscal Year 2000 (A-10-02-00008) July 25, 2003

Wisconsin

• Review of Wisconsin Medicaid School-Based Services Program for the Year Ending June 30, 2000 (A-05-02-00023)

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GAO Reports

National

• Questionable Practices Boost Federal Payments for School-Based Services
• Improper Payments Demand Improvements in HFCA Oversight
• Poor Oversight and Improper Payments Compromise Potential Benefit

Investigations top

National

• Report to Senate Committee on Finance - Gratuities Provided to Officials Responsible for the Procurement of Michigan School-Based Medicaid Consulting Services - September 8, 2000
  

• Thursday, June 12, 2003 The Committee on Energy and Commerce, which has exclusive jurisdiction over Medicaid, is conducting an investigation into potential waste, fraud and abuse in this Federal-State health care program for the needy.

Oregon

• Eagle Point's Jackson County School District 9 has agreed to pay $1.2 million

New York State

Links to Information on Senator Schumer's Web Page:

• The Senator's Press Release
• Fact Sheet - Potential Impact on NY schools by Region
• Senator Schumer's letter to Ashcroft.
• Senator Schumer's letter to Thompson.
• Regional summary of claims by school year. (NYSDOE Web Page)
• Schumer: Justice Dept Probe Into New York School Medicaid Claims on Hold For Now

Other Links

• Link to House of Representative's Committee on Education and the Workforce page on REFORMING & REAUTHORIZING The IDEA
• Link to Daily Messenger Article
• Link to Buffalo News Article
• Link to May 8, 2002 articles in Education on The Web -
  • Medicaid Money Goes Untapped By Many Schools
  • New York, Meanwhile, May Have to Repay Medicaid Money
  • Link to May 7, 2002 article in School Board News
  • Schools Decry New Guidance on Medicaid - January 22, 2003

Legal Actions top

• Federal False Claim Act $22 million judgment revived against New Orleans school The Associated Press 9/19/03 8:41 AM UNITED STATES OF AMERICA ex rel. WILLIAM GARIBALDI AND CARLOS SAMUEL VERSUS ORLEANS PARISH SCHOOL BOARD, CIVIL ACTION NO . 96-0464 SECTION "K" UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF LOUISIANA 2003 U.S. Dist. LEXIS 16547 September 17, 2003, Decided September 18, 2003, Filed, Entered

• 3/11/2003 Supreme Court Rules School Districts Maybe Sued Under Whistle Blower Act

• FIRST AMENDED COMPLAINT FOR DAMAGES AND OTHER RELIEF UNDER THE FALSE CLAIMS ACT

UNITED STATES OF AMERICA, ex rel TONI R. BARRON AND VICKY J. SCHEEL, Plaintiffs

vs. NO. SA-99-CV-1093FB

CIVIL ACTION DELOITTE & TOUCHE, LLP, DELOITTE & TOUCHE
CONSULTING GROUP, LLC.,DELOITTE & TOUCHE CONSULTING GROUP
HOLDING, LLC, MEDICAID SOLUTIONS OF TEXAS, and
NATIONALHERITAGE INSURANCE COMPANY, Defendants

• Texas Association of School Board's Article on Above action - This is not related to the above. slow link.

• DAB Reply to Medicaid Agencies Request for Reconsideration of Decision 1624 - The "Oklahoma" Decision., Download word version

Federal Hearings top

US Senate

• April 5, 2000 Senate Finance Committee Hearing on Medicaid School Payments

Federal Policy Releases, Including HIPAA and FERPA top

• OIG Compliance Program Guidance for Third-Part Medical Billing Companies
  
• 4/03/2003 - Corporate Responsibility and Corporate Compliance: A Resource for Health Care Boards of Directors
  
• HIPAA does not require additional consent.
  
• The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
  
• CEDAR RAPIDS COMMUNITY SCHOOL DISTRICT - WRIT OF CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE EIGHTH CIRCUIT BRIEF FOR THE UNITED STATES AS AMICUS CURIAE

  Publication from The Centers for Medicare & Medicaid Services, CMS (formerly The Health Care Financing Administration, HCFA.)

  • Final Medicaid Administrative Claiming Guide Issued May 2003 - GUIDE, COVER LETTER
  • DRAFT - FEBRUARY 2000: MEDICAID SCHOOL-BASED ADMINISTRATIVE CLAIMING GUIDE
  • Federal Medicaid's August 1997 Technical Assistance Guide on Medicaid and School Health
  • Testimony on Medicaid Coverage of School-Based Services by Sally Richardson June 17, 1999
  • SMD Letter - Reimbursement for School-Based Health Services Under Medicaid - 5/21/99
  • Testimony of Timothy Westmoreland, Director Center for Medicaid & State Operations, HCFA on Medicaid Payment for School-Based Services before the Senate Finance Committee on April 5, 2000

Federal Correspondence top

June 17, 2008 letter to US DOE

Federal Medicaid Email response to our question on the rumor the Medicaid program is ending.

School Medicaid USDOE Letters

April 16, 2001 USDOE letter on Medicaid Supplanting

July 22, 1997 USDOE letter on parental written consent required under the Family Educational Rights and Privacy Act (FERPA) when billing Medicaid

2002 Letter to South Carolina On Parental Consent and Medicaid

2002 Letter on use of Medicaid funds by LEA's

Other Federal Reports

1991 Medicaid Coverage of Health-Related Services for Children Receiving Special Education: An Examination of Federal Policies. Sometimes referred to as the :Lewin Report

 

State Policy Releases top

Colorado Electronic Transaction Act

Connecticut Electronic Transaction Act

New York Electronic Signature Policy

Wisconsin School Based Service Provider Manual

Wisconsin Electronic Signature Guidance

New York School Medicaid Manual

Oregon Attorney General's Opinion HIPAA vs., FERPA

State Correspondence top

New York

June 1999 letter on Medicaid's responsibility to pay in full for private duty nursing provided in schools

 

Other Articles top

U.S. Is Seeking Return of Funds From Schools

Federal Education's History Of the IDEA

American Speech-Language-Hearing Association Draft Position Statement and Technical Report: Medicaid Guidance for Speech-Language Pathology Services: Addressing the “Under the Direction of” Rule 8/23/2004.

American Speech-Language-Hearing Association June 2003 Article: Medicaid School Billing Under Fire

Article in Health and Health Care in Schools HHS Urged to Clarify ‘Payer of Last Resort’ in School Medicaid Reimbursement

Common Cause article - The Collector Sector

 

Other Resources top

Other Information Sources Of Use to Those Interested in Medicaid, the IDEA and FERPA

Click on link below to go toThe Special Ed & MedicaidKnowledgeBase. This site gathers the most pertinent information from a variety of sources in one place. The data is then organized and distilled to just the information you need when you need it.Developed by the Region VII Comprehensive Center & Northrop Grumman Information Technology.



State Coverage Initiatives

Murphy's Unofficial Medicaid Page

US Census Data on School District Poverty