Audit 376290

2025-005 – Medicaid – Allowable Activities and Costs Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Medical Assistance Program Assistance Listing Number: 93.778 Pass-Through Agency: WI DHS Pass-Through Entity Identifying Number: N/A Award Period: July 1, 2024 – June 30, 2025 Exceptions: 10 exceptions out of 25 tested (40.00%) Questioned Costs: $6,180 Type of Finding: Compliance Finding and Material Weakness in Internal Control Over Compliance and Other Matter Criteria: For a district to bill Medicaid for School Based Services (SBS) the district must have a signed “Consent to Bill Wisconsin Medicaid for Medically Related Special Education and Related Services” for each eligible student and services billed must be included in the students individualized evaluation plan (IEP). Covered SBS services include nursing, occupational and physical therapy, psychological services, counseling and social work, speech-language pathology, audiology, and hearing, transportation, and attendant care. Condition: The District has not properly implemented controls to oversee the Medicaid billing process and update student IEP’s for changes. Cause: The District did not ensure that services billed for reimbursement were included in the students’ IEP. Effect: The allowable cost requirements applicable to the grant were not met. Recommendation: We recommend management monitor billings and ensure prior to billing the services are included in the students current IEP. Management’s Response: The District is aware of the requirements and will attempt to compile the information necessary in the future. Responsible Officials: Beth Munson, Director of Business Services and Lisa Blochwitz, Director of Student Services Anticipated Completion Date: The District intends to work towards resolving this finding for the following year.