{"id":304064,"date":"2026-07-23T20:10:09","date_gmt":"2026-07-23T20:10:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-ny\/304064\/"},"modified":"2026-07-23T20:10:09","modified_gmt":"2026-07-23T20:10:09","slug":"nyc-public-schools-failed-to-claim-432m-in-medicaid-payments-comptroller","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-ny\/304064\/","title":{"rendered":"NYC Public Schools failed to claim $432M in Medicaid payments: comptroller"},"content":{"rendered":"<p>New York City Public Schools <a href=\"https:\/\/comptroller.nyc.gov\/wp-content\/uploads\/documents\/N25Vendor0008.pdf\" rel=\"nofollow noopener\" target=\"_blank\">failed to claim $431.6 million<\/a> in federal Medicaid reimbursements for special education services, costing the city a hefty sum as it <a href=\"https:\/\/www.nydailynews.com\/2026\/01\/28\/mayor-mamdani-launches-push-to-tax-the-wealthy-as-he-blames-nyc-12-billion-budget-gap-on-adams\/\" rel=\"nofollow noopener\" target=\"_blank\">stared down a structural budget gap<\/a> not seen since the Great Recession, according to a city comptroller\u2019s audit released Thursday.<\/p>\n<p>Of the 17.2 million documented therapy sessions provided to 145,000 students with disabilities over the audit period, education officials submitted claims for only 9.3 million, or slightly more than half, City Comptroller Mark Levine found. Federal Medicaid policy prevents the filing of reimbursement claims if just one document is missing.<\/p>\n<p>In some cases, the city\u2019s school system had no record at all of providing eligible services to students who were legally entitled to them \u2014 raising questions of whether the city is leaving money on the table or <a href=\"https:\/\/nymag.com\/intelligencer\/article\/carter-case-lawsuit-new-york-city-education-special-education-tuition.html\" rel=\"nofollow noopener\" target=\"_blank\">failing to support some children with disabilities<\/a>.<\/p>\n<p>\u201cFailing to collect Medicaid reimbursements the City is entitled to is more than a fiscal problem \u2014 it raises serious questions about whether government is operating as effectively as New Yorkers need it to,\u201d Levine said in a statement.<\/p>\n<p>\u201cWhen NYCPS cannot reliably claim federal dollars for services it already provides, and cannot consistently document whether mandated services were delivered, students, families and taxpayers all lose.\u201d<\/p>\n<p>In a formal response included in the audit, education officials wrote that they disagreed with \u201ckey assumptions\u201d behind Levine\u2019s estimates of lost revenue. One major concern is the audit uses gross reimbursement numbers \u2014 in practice, the state deducts half of reimbursements, so the city stands to benefit less than calculated by the comptroller.<\/p>\n<p>\u201cThis report contains assumptions and misconceptions that significantly overstate what can realistically be reimbursed in the current structure,\u201d Nicole Brownstein, a public schools spokeswoman, added in a statement. \u201cWe will continue pursuing every operationally feasible reimbursement opportunity to maximize available resources and <a href=\"https:\/\/www.nydailynews.com\/2026\/07\/14\/mamdani-expands-key-autism-school-programs-to-pre-k-amid-universal-childcare-push\/\" rel=\"nofollow noopener\" target=\"_blank\">ensure every student receives the resources they deserve<\/a>.\u201d<\/p>\n<p>Between July 2022 and June 2025, auditors found the school system claimed reimbursement for only 54% of documented occupational, physical or speech therapy sessions, resulting in at least $273.4 million in foregone Medicaid revenue.<\/p>\n<p>Education officials also failed to document \u2014 or potentially failed to provide \u2014 roughly 16% of eligible services to students with disabilities as legally required by their individualized education programs, according to the comptroller.<\/p>\n<p>If those services were provided, but not recorded, that would result in an additional $132.8 million in lost revenue \u2014 though the school system maintained it was inappropriate to draw such conclusions and the estimate was speculative.<\/p>\n<p>\u201cEither NYCPS simply did not provide a significant percentage of required therapy services,\u201d auditors wrote, \u201cin which case children did not receive services that were considered medically necessary to thrive in their school environments \u2014 or NYCPS provided the services but did not collect any documentation needed to seek Medicaid reimbursement for them.\u201d<\/p>\n<p>The school system also did not bill Medicaid for certain services \u2014 including evaluations, re-evaluations and psychological counseling, <a href=\"https:\/\/www.nydailynews.com\/2023\/10\/25\/nyc-students-with-disabilities-file-federal-civil-rights-complaint-over-transportation-woes\/\" rel=\"nofollow noopener\" target=\"_blank\">special transportation<\/a> and nurses \u2014 that Levine said are covered by the federal program.<\/p>\n<p>The comptroller called on the city to strengthen its documentation systems and \u201censure every eligible dollar is claimed and every required service is tracked.\u201d<\/p>\n<p>Mayor Mamdani in January sounded the alarm about a possible $12.6 billion budget gap over two fiscal years, lacing into former Mayor Eric Adams for a pattern of under-budgeting that set the city on a path to a historic shortfall. The gap was ultimately closed with the <a href=\"https:\/\/www.nydailynews.com\/2026\/02\/16\/hochul-sends-more-funds-nyc-mamdani-budget-plan-taxes\/\" rel=\"nofollow noopener\" target=\"_blank\">help of Gov. Hochul<\/a> and <a href=\"https:\/\/www.nydailynews.com\/2026\/05\/12\/mamdani-hochul-4-billion-state-cash-no-property-tax\/\" rel=\"nofollow noopener\" target=\"_blank\">deferring the city\u2019s pension fund payments<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"New York City Public Schools failed to claim $431.6 million in federal Medicaid reimbursements for special education services,&hellip;\n","protected":false},"author":2,"featured_media":304065,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[115253,115252,115251,115254,9,24,55,54,56,8229],"class_list":["post-304064","post","type-post","status-publish","format-standard","has-post-thumbnail","category-new-york-city","tag-budget-crunch","tag-comptroller-mark-levine","tag-medicaid-reimbursements","tag-mismanagement","tag-new-york","tag-new-york-city","tag-new-york-city-headlines","tag-new-york-city-news","tag-ny","tag-nyc-public-schools"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/posts\/304064","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/comments?post=304064"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/posts\/304064\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/media\/304065"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/media?parent=304064"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/categories?post=304064"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/tags?post=304064"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}