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EXECUTIVE SUMMARY:
The objective of this audit was to determine whether costs claimed for school-based health services by the Springfield Public Schools through the Commonwealth of Massachusetts were reasonable, allowable and adequately supported in accordance with the terms of the state Medicaid plan and applicable federal regulations. The audit period included Medicaid payments made during the period July 1, 1999 through June 30, 2000.
We found Springfield Public Schools inappropriately claimed the cost of school-based health services when documentation was inadequate, providers did not have required qualifications, students were absent, and for days when schools were not open to students. As a result, we estimate that the Springfield Public Schools were overpaid at least $574,034. We made procedural recommendation to Springfield Public Schools to address these issues. We also recommended that Springfield Public Schools refund amounts that were inappropriately paid by the Medicaid program. Springfield Public Schools officials disagreed with the findings and recommendations regarding documentation of services and provider qualifications. Springfield Public Schools generally agreed with the finding and recommendations concerning attendance.