Finding #2022-004 ? Services billed that were not identified in the student?s IEP. Medical Assistance Program (Medicaid; Title XIX) (93.778) Federal Grantor ? U.S. Department of Health and Human Services Pass-through Entity ? Wisconsin Department of Health Services Condition: Covered school based services billed to Medicaid must be identified within the child?s IEP. A child?s billing sampled during the audit included nursing and transportation services. These services were not listed in the child?s IEP. Questioned costs: $654.12 Criteria: Students with covered services billed to Medicaid must have the services listed within the child?s IEP. Effect: Potentially unallowable billings arise when services are not included within the IEP of students. Cause: Nursing and transportation services were omitted from the child?s IEP, yet were billed to Medicaid. The District did not review the child?s IEP against services billed to ensure compliance. Recommendation: The District should only bill Medicaid for covered services included in IEP. The IEP should be reviewed prior to services being provided and billed to Medicaid. Also, the District should be reviewing the files on a regular basis to ensure compliance with this requirement. Response: We will review the District?s requirements and procedures for billing Medicaid and make any necessary changes to ensure completeness and accuracy. Contact Person: Tracy Case Anticipated Completion: December 31, 2023