New York State Department of Social Services, DAB No. 819 (1986)

DEPARTMENTAL GRANT APPEALS BOARD

Department of Health and Human Services

SUBJECT: New York State Department of
Social Services

Docket No. 86-208
Decision No. 819

DATE: December 15, 1986

DECISION

The New York State Department of Social Services (State) appealed the
disallowance by the Health Care Financing Administration (Agency) of
$31,097 (out of a total disallowance of $110,445) in federal financial
participation claimed by the State under Title XIX (Medicaid) of the
Social Security Act (Act). The State did not specify in its notice of
appeal whether the expenditures in the amount appealed were made before,
or on and after, October 1, 1979.

The Agency relied, for the disallowance of the claims for expenditures
made prior to October 1, 1979, on section 306(b) of Pub. L. 96-272, and
46 Fed. Reg. 3528 (January 15, 1981), which provided that claims for
such expenditures had to be filed by May 15, 1981. For the claims for
expenditures from October 1, 1979 forward, the Agency relied on section
1132 of the Act and 45 CFR 95.7, which required that these claims be
filed within two years after the calendar quarter in which the state
agency made the expenditures. The Agency also stated in the
disallowance that none of the exceptions in 45 CFR 95.19 were
applicable.

None of the expenditures were made later than March 31, 1984, and all
the expenditures were claimed on a Quarterly Statement of Expenditures
dated June 6, 1986, which was in any event later than the filing
deadlines referred to above.

The State requested the Board to issue a summary decision based upon our
holding in New York State Department of Social Services, Decision No.
521, March 6, 1984. 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, and which the Board
rejected in Decision No. 521. 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 submitted no new argument why
Decision No. 521 was wrong.

We conclude that the claims of $31,097 disallowed here are barred by
statutory and regulatory filing requirements and sustain the
disallowance of this amount, based on Decision No. 521, which we
incorporate herein.


________________________________ Judith
A. Ballard


________________________________ Donald
F. Garrett


________________________________
Alexander G. Teitz
Presiding Board