Finding Text
Finding 2025-002: Significant Deficiency - Internal Control and Compliance over Activities Allowed/Allowable Costs and Special Tests and Provisions Program: Grants to States for Medicaid (School Based Services) - Medicaid Cluster Assistance Listing Number: 93.778 Pass-Through Agency: Wisconsin Department of Health Services/CESA 11 Criteria: In accordance with Wisconsin Department of Health Services, the District is required to have a signed and dated Consent to Bill Wisconsin Medicaid for Medically Related Special Education and Related Services form (consent form) on file for each recipient. Condition/Context: For one of seven recipients selected for testing, a signed and dated consent form was not on file. The sample was not statistically valid. Cause: The District was unable to locate the signed and dated consent form required to be retained in accordance with program requirements. Effect: The absence of a required signed and dated consent form may result in errors in billing Wisconsin Medicaid for medically related special education and related services, potentially leading to disallowed costs or repayment obligations. Questioned Costs: Questioned costs for ALN 93.778 include $928 of services for the recipient without documentation of the signed and dated consent form. Recommendation: We recommend the District reevaluate its control structure to ensure there is adequate review to verify that every recipient has a signed and dated consent form on file prior to billing Medicaid. Views of Responsible Officials: Management agrees with finding 2025-002 and will make efforts to implement recommended procedures.