An audit of school supportive health services in the Newburgh City School District found that it overcharged taxpayers more than $278,000.  The district must now repay that amount to the state Medicaid program, according to the New York State Office of the Medicaid Inspector General (OMIG), which conducted the audit.

The audit found that, in 57 billed services related to 52 students, progress notes were not reviewed or cosigned by a reviewer.  Additionally, OMIG auditors discovered that, in 49 billed services related to 42 students, no record had been kept of supervision or direction by meeting with the child prior to services and then again on a periodic basis.  Other findings included missing progress notes from therapists, as well as missing student and therapist attendance notes.  Student goals and progress are assessed by looking at these records and measurements.

Reimbursement under the Medicaid program is available under the School Supportive Health Services Program and Preschool Supportive Health Services Program (SSHSP and PSHSP) for diagnostic and health support services provided to students who have been diagnosed with or who are suspected of having disabilities.  SSHSP applies to the 5 to21-year-old population, and PSHSP applies to the 3to 4-year-old population.

“Effective school supportive services help young people achieve their best results,” said Medicaid Inspector General James C. Cox. “Without proper oversight or review, OMIG, cannot ensure that proper services have been delivered.”

The final report for this audit, which covered four years of Medicaid-funded services (#11-2972), is available on OMIG’s Web site (www.omig.ny.gov) under the final audit report section.

New Yorkers can assist the Office of the Medicaid Inspector General in fighting fraud, waste, and abuse by reporting potentially suspicious behavior or incidents.  OMIG encourages anyone who observes instances of potential Medicaid fraud, waste, or abuse to contact OMIG’s fraud hotline at 1-877-87-FRAUD or visit the Web site at www.omig.ny.gov. Tips can be completely anonymous, and OMIG investigates information from all calls.

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Our mission is to enhance the integrity of the New York State Medicaid program by preventing and detecting fraudulent, abusive, and wasteful practices in the Medicaid program and recovering improperly expended Medicaid funds while promoting high-quality patient care.

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