Alert #06-1


New York State, Office of the Medicaid Inspector General (NYS OMIG)

School/Preschool Supportive Health Services Program (SSHSP/PSHSP)

Medicaid in Education Unit

Issue #06-1

TO: All SSHSP/PSHSP Medicaid Providers

FROM: NYS OMIG SSHSP/PSHSP Medicaid in Education Unit

DATE: May 11, 2006

SUBJECT: PSHSP Corrective Action Reviews

This alert is to inform all PSHSP providers that corrective action reviews of preschool Medicaid claims will begin this spring. Staff from the NYS Office of the Medicaid Inspector General (OMIG) will be contacting each county to initiate the process.

The review will consist of all services and evaluations, approximately 10 to 30 claims per rate code, which the county claims for reimbursement. Most of the claims that will be reviewed will have been paid by Medicaid within the last twelve to fifteen months prior to the start of the review.

School districts should be aware of their responsibilities for this initiative, since the school districts develop the Individualized Education Programs (IEPs) that the preschool programs use, and the Committees for Preschool Education (CPSE) determine which evaluations need to be completed. Therefore, despite the fact that the counties are fiscally responsible for the services, and are the target of the corrective action reviews, the individual school districts and preschools may maintain some of the requisite documentation. School districts and preschools will be required to produce copies of documentation that counties may ask for to document their claims.

Last Updated: June 5, 2009