Audit of the Iowa Department of Human Services' Claim for Medicaid School-Based Administrative Costs

EXECUTIVE SUMMARY:

The objective of this review was to determine whether school-based administrative expenditures claimed by Iowa in State fiscal years 1998 through 2001 were reasonable, allowable, and in accordance with applicable Federal regulations, cost principles, and the approved Medicaid State plan.  For the audit period, Iowa reported total costs of $26.8 million and claimed $15.2 million in FFP.  Iowa did not properly monitor the school-based health services administrative cost program.  We determined Iowa:  (1) claimed $631,047 in Federal financial participation (FFP) without the required matching expenditures at seven non-public agencies, (2)inappropriately claimed $22,535 due to spreadsheet rounding errors, and (3) did not adequately monitor lead agency and sub-agency claims as they related to revenue offsets, allocation bases, use of enhanced FFP rates, and reasonableness of time studies for determining costs attributable to the program.