Review of Oregon's Medicaid Payments for School-Based Health Services Direct Care in State Fiscal Year 2000

EXECUTIVE SUMMARY:

The objective of this review was to determine whether the medical assistance costs claimed by the Oregon State Department of Human Services (Oregon) for the school-based health services direct care program (Program) were allowable and adequately supported.  We determined that Oregon:  (1) claimed Program expenditures of three educational providers that were unallowable for federal financial participation and (2) established reimbursement rates for group therapies, screenings, and contracted consulting services and rate increases that were not developed in accordance with federal regulations.  Based on a statistical sample, we estimated the errors for the three sampled educational providers to be at least $277,688 ($166,671 federal share).  We recommended procedural corrections and a financial adjustment totaling $166,671.  Oregon concurred with our findings and recommendations.