Clarifying The Cost Report, Agreed-Upon Procedures, And More It feels like we just completed the round of Medicaid school program (MSP) cost reports and agreed-upon procedures for the period ending June 30, 2019 – and here we are starting the process of collecting data for the period ending June 30, 2020. The completion of the June 30, 2019 engagements resulted in the Ohio Department of Medicaid issuing approximately $75 million in cost settlements! We know how important this program is to all of you, and we want to work with you to get this next round completed. To get ready for this next round, we would like to invite all of you to this free, hour-long webinar. The MSP team from Rea & Associates will provide you tips for preparing for this round of agreed-upon procedures, a section-by-section update, and common issues we identify during the engagement. Find out why it's important for iep parental consent and how agreed upon procedures can put your district in a position to succeed. Ready To Learn About The 2020 Medicaid School Program? During this free, hour-long webinar for Ohio school districts, you'll: - Gain insight on how to prepare for agreed-upon procedures. - A section-by-section walkthrough with industry professionals and tips on how to identify and avoid potential hurdles. - Insight on common issues that may arise during the engagement. - And so much more ... This informative webinar is presented by two leaders on Rea & Associates government services team, Zac Morris and Ken Richards. The duo is coming prepared to present the insight and technical information you need to ensure compliance with the 2020 Medicaid School Program. For more information, visit the Rea & Associates' website at https://www.reacpa.com. As a top 100 CPA firm and professional services organization, Rea's government services team is committed to providing you with the tools and insight you need to drive effectiveness and efficiency throughout your entity. #MedicaidSchoolProgram #CostReporting #AgreedUponProcedures #ReaCPA

2. Your Rea Team
• Tracey Campbell, Client Service Specialist - Gahanna
• AJ Knapp, Manager – Millersburg
• Laura Nijmeh, Manager – Gahanna
• Stephen Roberts, Senior Associate – Gahanna

4. Ohio Medicaid School Program (MSP)
Reimburses Ohio school districts for costs associated with providing IEP Evaluation
and Therapy services (related services) to students that have Medicaid insurance
coverage. Current reimbursable services are IEP Speech, Audiology, OT, PT,
Psychology, Nursing, Counseling, Social Work, and Specialized Transportation.
Medicaid Reimbursement
MSP reimbursement is generated from two different processes:
• Interim Claiming - Based on therapist service documentation.
Example: Units of service provided x Interim Unit Rates x FMAP % = Interim Claiming
(monthly checks)
• Final Settlement - Based on costs reported on the MSP Cost Report.
Example: Total Reimbursable Costs less what was paid during Interim Claiming
(annual lump-sum payment)

5. Agreed Upon Procedures (AUP)
Review
• Very unique process in which your program and cost report
go through a detailed review before final funds are
distributed.
• This is your AUP and is paid for by your school district.
• This is a review of your systems as well as a review of your
billing vendor’s services.
• Although no-one likes audit adjustments, how can issues be
corrected if they are not reported.
• Try to get your cost report data to your billing vendor and
your AUP data to your CPA firm as efficiently as possible.
• Cooperation = Quicker Final Settlement

7. MSP Agreed Upon Procedures
• Purpose of the
procedures is to test
items highlighted in
the cost report that
drive reimbursement
• Payroll
• Paid claims
• Fixed assets
• Statistics
• RMTS
• Statistics
• Transportation
• Procurement
• Non-payroll

8. Parties involved in the MSP Process
• Ohio Department of Medicaid (ODM)
• Ohio Department of Education (ODE)
• Billing Agency
• CPA Firm
• School

9. Timeline of MSP AUP Engagement
• Claim Payment Report
• Cost Report
• Engagement Letter (AUP Procedures)
• Information Request from Billing Agent
• Initial Information Request from Rea
• Subsequent Information Requests from Rea
• Completion of engagement and submission of cost
report
• Deadline of December 31, 2021

10. Information Requests
• Information Request from Billing Agent
• Information needed to compile cost report (payroll registers, check
registers or similar reports, invoices, service contracts, etc.)
• Initial Information Request from Rea
• Paid Claims - IEPs, attendance, parental consents
• Subsequent Information Requests from Rea
• Outstanding information from Initial Information Request
• Payroll Information – contracts (including supplemental contracts),
job descriptions, IDCR letter, support for federal fund payments,
payroll reports
• Transportation – information to determine specially adapted
transportation vehicle
• Procurement and Nonpayroll - cancelled checks and invoices,
student listings from vendor, information regarding methods and
rationale for selection of vendor, service contracts, accounting
reports (check register, FINDET, etc.)

12. Sharefile
• Secure
• Allows larger files to be uploaded at one time
• Everyone in the company has access
• Anyone can be added
• Preferred method
• Directions attached

16. Final Report
• Format of the report.
• Main exceptions found.
• IEP signed by a qualified practitioner.
• Attendance record verifying student was in school date
service was provide.
• Parental consent forms.
• IEP covering service date not provided.
• Review of report by Treasurer.

18. Summary
• Make certain that your district is billing for all available
services.
• Make sure that all therapists are documenting all IEP
services.
• Be sure to capture all allowable costs on the cost report.
• Obtain an Indirect Cost Rate (ICR) when advantageous.
• UG Procurement Standards apply to MSP
• Get signed parental consent forms for all IEP students.
• Review AUP final report and understand the findings.
• Correct any AUP findings as soon as possible.
• Communicate with all district stakeholders.

19. Contact Us
• Zac Morris – Zac.morris@reacpa.com
• Ken Richards – Ken.Richards@reacpa.com
• Laura Nijmeh – Laura.Nijmeh@reacpa.com
• AJ Knapp – AJ.knapp@reacpa.com
• Stephen Roberts – Stephen.Roberts@reacpa.com
• Tracey Campbell – Tracey.Campbell@reacpa.com