Audit of Early Intervention Payments by the Department of Health and Mental Hygiene

Audit Report In Brief

This audit determined whether New York City Department of Health and Mental Hygiene (DOHMH) payments for early intervention services are valid and accurate.

Our review of DOHMH’s Fiscal Year 2003 payments for early intervention services found that they were valid and accurate. DOHMH had adequate internal control procedures and segregation of duties for the authorization, delivery, and payment of services. Generally, adequate backup documentation exists to support provider payments, the correct billing information was submitted by the providers, and the correct amounts were used to calculate the service coordination units.

However, DOHMH did not complete financial audits of service providers in a timely manner. In addition, although not part of our audit objective, we note that many providers complained about the timeliness of payments for early intervention services. We also noted that there were problems in correcting errors within the statewide management information system database called Kid Integrated Data System (KIDS). In addition, KIDS did not flag in a timely manner that needed insurance information was absent. These issues are discussed in greater detail in the following sections of the report and warrant management’s attention, but they did not affect our overall conclusion regarding the validity and accuracy of the DOHMH payments.

Based on our findings, we make seven recommendations, including the following:

DOHMH officials should:

•  Ensure that its audit bureau conducts and completes financial audits annually.

•  Meet with providers to discuss the issues raised in this report and ways to improve the timeliness of payments.

•  Meet with appropriate State officials to discuss ways to reconfigure KIDS to better match DOHMH’s needs.

The matters covered in this report were discussed with DOHMH officials during and at the conclusion of this audit. A preliminary draft report was sent to DOHMH officials and discussed at an exit conference held on April 22, 2005. On May 9, 2005, we submitted a draft report to DOHMH officials with a request for comments. We received a written response from DOHMH on May 25, 2005. Though DOHMH officials did not agree with our findings, they generally agreed with our recommendations. In their response DOHMH officials expressed concern about the audit report’s presentation, stating:

“We are concerned that positive findings are followed by a disproportionately high number of relatively minor comments and suggestions, many of which are based on unsubstantiated assertions of Early Intervention providers.”

Auditor Comment: We prepared this report to reflect the audit’s findings accurately with respect to the audit’s objective. We have taken care to note those issues outside the audit objective that came to our attention; and we discuss those issues fully to document what we found in the course of the audit and to provide a clear basis for understanding the audit recommendations.