St. Regis Falls school district addresses audit findings

ST. REGIS FALLS — A recent state Comptroller's Office audit found the St. Regis Falls Central School district did not maximize Medicaid reimbursements for services provided, and the district is working to address 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 translated to $11,530 in revenue.

The Comptroller's Office said services provided but not submitted and reimbursed included speech therapy, occupational therapy, physical therapy and psychological counseling. These were provided by district employees, Brushton-Moira Central School District staff and third-party providers.

Reasons the claims were not submitted or reimbursed included that they were not properly documented, were not submitted even if all documentation requirements were met, and that claims with submission errors were not corrected and resubmitted, the audit said.

The auditors recommended district officials:

• Establish procedures to ensure all documentation requirements are met to submit Medicaid claims for reimbursement for all eligible services provided.

• Review documentation of claims submitted for reimbursement by the special education assistant.

• Reconcile the amounts claimed for Medicaid reimbursement with the amounts received and review any rejected or disallowed claims to determine whether they may be resubmitted.

• Review all the unclaimed services identified in the audit report and submit any eligible claims for reimbursement.

• Correct and resubmit the rejected claims identified in the audit report for reimbursement.

District Treasurer Michael Tallman said in a statement that the district takes all the findings very seriously.

“We worked collaboratively with the Comptroller’s Office to identify these issues, and we’re now doing everything we can to ensure that we claim every dollar that can be reimbursed to the district through Medicaid.”

District administrators and the school board's audit committee put together a corrective action plan that includes new policies that set up a timeline for providers to submit their service notes, a regular schedule for the business office to check reimbursements and monthly meetings to ensure that the new action plan items are being kept up, according to a press release.

The plan is currently being implemented.