New York State Department of Social Services, DAB No. 748 (1986)

GAB Decision 748

April 29, 1986

New York State Department of Social Services; 

Docket No. 86-33
Bsllard, Judith A.; Teitz, Alexander G.  Settle, Norval D.

The New York State Department of Social Services (State) appealed the
disallowance of $1,978,995 in federal financial participation by the
Health Care Financing Administration (HCFA) under Title XIX (Medicaid)
of the Social Security Act (Act).  The disallowance represented claims
submitted by the State for 15 percent incentive payments for medical
support enforcement activity for the period July 1984 through March
1985.  HCFA determined that the documentation submitted by the State in
support of its claims did not demonstrate that the gross collections
against which the 15 percent had been calculated were in fact the
results of enforcement and collection activity undertaken by a political
subdivision of New York State or by another state pursuant to
cooperative agreements in accordance with sections 1903(p)(1) and
1912(a)(1) of the Act.

The Board dealt with essentially the same issues concerning incentive
payments for enforcement and collection efforts in New York State
Department of Social Services, Decision No. 628, March 19, 1985.  The
State requested the opportunity to verify whether political subdivisions
reporting expenditures duly distinguished between allowable Child
Support Enforcement and other collections in calculating the 15 percen
payment for medical support enforcement activity.  The State asserted
that, once the figures used by HCFA in reaching the disallowance were
verified, it would stipulate to the disallowance being sustained based
upon Decision No. 628, without the necessity of further proceedings.
See, Appellant's letter to the Board dated February 12, 1986.

The Board gave the State the opportunity to examine HCFA's calculations.
The State then submitted documentation showing that the disallowance
should be reduced by $30,122.  HCFA reviewed the State's submission and
agreed that the disallowance should be so reduced.  See, Respondent's
letter to the Board dated April 16, 1986.(2)

We therefore sustain the disallowance in the reduced amount of
$1,948,873, based on Decision No. 628, which we incorporate herein.

MARCH 28, 1987