Review of School-Based Health Services in Kansas

EXECUTIVE SUMMARY:

This audit was part of a multistate initiative.  Our objective was to determine whether Kansas claimed costs for school-based health services provided by selected school districts for fiscal year 2002 in accordance with Federal requirements and the State plan.  Kansas claims some costs that were not in accordance with Federal requirements and the State plan.  Our review of 300 sampled claims showed that 217 claims were unallowable for Medicaid reimbursement, including 139 claims for services that were not rendered and 78 claims that did not have required prescriptions or referrals.  In addition, many sampled claims lacked documentation. 

We recommended that Kansas (1) refund $5.1 million to the Federal Government, (2) calculate and refund the portion of $126.8 million (Federal share) paid to school districts outside of our sample that does not qualify for reimbursement, (3) provide correct instructions to schools, and (4) ensure that school districts maintain required documentation.  Kansas did not agree with our recommendations to refund but did agree to provide correct instructions and ensure that schools maintain documentation.