GAB Decision 768
July 16, 1986
New York State Department of Social Services;
Control No. 86-96
Ballard, Judith A.; Garrett, Donald F. Teitz, Alexander G.
The New York State Department of Social Services (State) appealed
part of the disallowance by the Health Care Financing Administration of
$259,954 in federal financial participation (FFP) claimed by the State
under the Medicaid program. The amount disallowed was claimed on a
revised Quarterly Statement of Expenditures submitted for the quarter
ending June 30, 1985 and dated September 3, 1985. The State appealed
only $159,541 of the amount.
The disallowance letter stated that the expenditure report included
local
district supplemental claims and Office of Mental Retardation
retroactive
claims, all of which related to periods prior to June 30,
1983. Of the
total amount disallowed, $11,518 FFP was claimed for
expenditures made prior
to October 1, 1979 and $248,436 FFP was claimed
for expenditures made between
October 1, 1979 and June 30, 1983. The
State did not dispute the dates
of the expenditures.
The disallowance letter stated that claims for expenditures prior
to
October 1, 1979, had to be filed by May 15, 1981, citing Pub.
L.
96-272, section 306(b), and 46 Fed. Reg. 3528 (January 15, 1981). As
to
expenditures made after September 30, 1979, claims had to be
filed
within two years after the calendar quarter in which the
expenditures
were made, as provided in section 1132 of the Social Security
Act and 45
CFR 95.7. The disallowance went on to say that since the
claims were
not filed until September 3, 1985, the filing deadlines were not
met,
and none of the exceptions to the time limits in 45 CFR 95.19 applied
to
these claims.
The State, in appealing only part of the disallowance, did not
identify
the claims appealed as being for expenditures made before or on or
after
October 1, 1979. However, since the claims were not filed
until
September 3, 1985, they were clearly untimely in any event.
The State in its notice of appeal 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(2) 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.
The State requested the Board to
issue a summary decision based upon our
holding in Decision No. 521. In
its notice of appeal the State
submitted no new argument why Decision No. 521
was wrong.
CONCLUSION
We conclude that the claims here are barred by statutory and
regulatory
filing requirements and sustain the disallowance of $159,541 based
on
Decision No. 521, which we incorporate herein.