GAB Decision 681
August 13, 1985
New York State Department of Social Services;
Ballard, Judith A.; Garrett, Donald F. Teitz, Alexander G.
Docket No. 85-116
DECISION
The New York State Department of Social Services (State) appealed the
disallowance of $604,142 (of a total disallowance of $633,504) in
federal financial participation (FFP) by the Health Care Financing
Administration. The disallowance was based on increasing adjustments
claimed on the Quarterly Statement of Expenditures for the Medical
Assistance Program (Title XIX) for the quarter ending December 31, 1984,
dated February 28, 1985. The grounds for the disallowance were that the
claims were unallowable because they were not filed within the
limitations for timely filing of claims in certain statutes and
regulations. The disallowance stated that $25,902 FFP pertained to
fiscal year (FY) 1979 and prior periods, and $607,602 FFP related to the
period from October 1, 1979 to December 31, 1982. The State appealed
the entire amount of $25,902 related to FY 1979 and prior periods, and
$578,240 of the $607,602 related to expenditures after FY 1979.
The disallowance stated that expenditures related to FY 1979 and prior
periods had to be filed by May 15, 1981, as required by 45 CFR 95.10 (46
Fed. Reg. 3527, January 15, 1981), and section 306(b) of Pub. L.
96-272. Claims for FY 1980 and forward had to be filed within two years
after the calendar quarter in which the State made the expenditures, as
required by section 1132 of the Social Security Act and 45 CFR 95.7.
None of the claims were filed until February 28, 1985, so the limitation
provisions were not met. The disallowance further stated that none of
the exceptions to the time limits in 45 CFR 95.19 applied to these
claims.
The State repeated the arguments pertaining to the applicability of the
relevant filing requirements which it had put forward in Board Docket
Nos. 83-170 and 83-180, decided in New York State Department of Social
Services, Decision No. 521, March 6, 1984. The State admitted that this
appeal does not present any material issues of fact which distinguish it
from Board Docket Nos. 83-170 and 83-180, and requested the Board to
issue a summary decision based upon our holding in Decision No. 521.
The State submitted no new argument why Decision No. 521 was wrong.(2)
We conclude that the claims here are barred by statutory and regulatory
filing requirements and sustain the disallowance of $604,142, based on
Decision No. 521, which we incorporate herein.
JANUARY 14, 1986