Review of Washington State's Medical Assistance Costs Claimed for School-Based Health Services Provided in State Fiscal Year 2000

EXECUTIVE SUMMARY:

The objective of this review was to determine whether medical assistance costs claimed by Washington State (State) for the school-based health services program were allowable and adequately supported.  We found the State did not adequately implement and monitor the program.  As a result, we determined the State submitted claims for unallowable costs for:  (1) services that were not covered under Medicaid or properly documented ($3,818,252); (2) billing fees that were not reimbursable ($573,728); and (3) services provided to children who were not Medicaid eligible ($15,819).  Based on a projection of a statistical sample, we estimated the errors to total at least $4,407,799 ($2,279,752 Federal share).  We recommended procedural improvements and a financial adjustment for $2,279,752.