Massachusetts Generally Complied With Medicaid Requirements When Claiming Reimbursement for School-Based Health Services

The Massachusetts Office of Medicaid (State agency) generally complied with Federal and State requirements when using random moment time studies to claim direct medical service costs related to Medicaid school-based health services for State fiscal year 2012. However, some districts may have claimed certain personnel costs twice, resulting in a potential overpayment of $720,000 ($377,000 Federal share) of the $91.5 million ($47.8 million Federal share) claimed. The New Bedford and Springfield school districts received overpayments of $31,000 ($16,000 Federal share) and $15,000 ($8,000 Federal share), respectively, because of errors in their cost reports. The State agency did not have internal controls to stop interim payments that districts claimed after the cost settlement process.