U.S. Department of Health and Human Services
Passed through the N.C. Department of Health and Human Services
Medical Assistance Programs
Assistance Listing # 93.778
Finding 2023-001
Nonmaterial Noncompliance – Eligibility
Criteria: The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NC FAST, and to ensure all required physical documentation is located in the file to properly document eligibility with program requirements. The County should ensure all countable resources are computed accurately and all income information is entered into NCFAST correctly.
Condition: There were 5 out of 60 participants tested with various filing errors noted below. Due to theCOVID-19 Public Health Emergency, there were waivers in place during the fiscal year in which prevented the termination of benefits. In all instances, participants were found to be eligible for benefits.
Questioned costs: None.
Context: There was one instance where the approval notice was not in case file but case was properly approved; one instance where OVS was generated but not documented on the Evidence dashboard; one instance where DMA-5097 was not in the case file; one instance where income was calculated incorrectly; and one instance where checking account amount was not included in resources.
Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk that the County could not immediately substantiate the eligibility determination.
Cause: The increased workload caused by the global pandemic, coupled with Federal and State directives to not reduce or terminate benefits leading to human errors regarding clerical and data entry activities.
Recommendation: Although this issue will occur from time to time considering the volume of case files that the County processes and maintains, we recommend procedures be reinforced by means of training to ensure all proper documentation is kept and maintained.
Management’s Response: Management agrees with the finding but wishes to stress that Federal directives mandated eligibility for all applicants. Although eligibility was not affected, DSS mid-management will continue to close any continuous quality improvement process issues as well as work to improve trainings / supervision to reduce these technical errors. The results of the Single Audit will be focus areas for monthly refreshers and future trainings.
U.S. Department of Health and Human Services
Passed through the N.C. Department of Health and Human Services
Medical Assistance Programs
Assistance Listing # 93.778
Finding 2023-001
Nonmaterial Noncompliance – Eligibility
Criteria: The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NC FAST, and to ensure all required physical documentation is located in the file to properly document eligibility with program requirements. The County should ensure all countable resources are computed accurately and all income information is entered into NCFAST correctly.
Condition: There were 5 out of 60 participants tested with various filing errors noted below. Due to theCOVID-19 Public Health Emergency, there were waivers in place during the fiscal year in which prevented the termination of benefits. In all instances, participants were found to be eligible for benefits.
Questioned costs: None.
Context: There was one instance where the approval notice was not in case file but case was properly approved; one instance where OVS was generated but not documented on the Evidence dashboard; one instance where DMA-5097 was not in the case file; one instance where income was calculated incorrectly; and one instance where checking account amount was not included in resources.
Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk that the County could not immediately substantiate the eligibility determination.
Cause: The increased workload caused by the global pandemic, coupled with Federal and State directives to not reduce or terminate benefits leading to human errors regarding clerical and data entry activities.
Recommendation: Although this issue will occur from time to time considering the volume of case files that the County processes and maintains, we recommend procedures be reinforced by means of training to ensure all proper documentation is kept and maintained.
Management’s Response: Management agrees with the finding but wishes to stress that Federal directives mandated eligibility for all applicants. Although eligibility was not affected, DSS mid-management will continue to close any continuous quality improvement process issues as well as work to improve trainings / supervision to reduce these technical errors. The results of the Single Audit will be focus areas for monthly refreshers and future trainings.
U.S. Department of Health and Human Services
Passed through the N.C. Department of Health and Human Services
Medical Assistance Programs
Assistance Listing # 93.778
Finding 2023-001
Nonmaterial Noncompliance – Eligibility
Criteria: The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NC FAST, and to ensure all required physical documentation is located in the file to properly document eligibility with program requirements. The County should ensure all countable resources are computed accurately and all income information is entered into NCFAST correctly.
Condition: There were 5 out of 60 participants tested with various filing errors noted below. Due to theCOVID-19 Public Health Emergency, there were waivers in place during the fiscal year in which prevented the termination of benefits. In all instances, participants were found to be eligible for benefits.
Questioned costs: None.
Context: There was one instance where the approval notice was not in case file but case was properly approved; one instance where OVS was generated but not documented on the Evidence dashboard; one instance where DMA-5097 was not in the case file; one instance where income was calculated incorrectly; and one instance where checking account amount was not included in resources.
Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk that the County could not immediately substantiate the eligibility determination.
Cause: The increased workload caused by the global pandemic, coupled with Federal and State directives to not reduce or terminate benefits leading to human errors regarding clerical and data entry activities.
Recommendation: Although this issue will occur from time to time considering the volume of case files that the County processes and maintains, we recommend procedures be reinforced by means of training to ensure all proper documentation is kept and maintained.
Management’s Response: Management agrees with the finding but wishes to stress that Federal directives mandated eligibility for all applicants. Although eligibility was not affected, DSS mid-management will continue to close any continuous quality improvement process issues as well as work to improve trainings / supervision to reduce these technical errors. The results of the Single Audit will be focus areas for monthly refreshers and future trainings.
U.S. Department of Health and Human Services
Passed through the N.C. Department of Health and Human Services
Medical Assistance Programs
Assistance Listing # 93.778
Finding 2023-001
Nonmaterial Noncompliance – Eligibility
Criteria: The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NC FAST, and to ensure all required physical documentation is located in the file to properly document eligibility with program requirements. The County should ensure all countable resources are computed accurately and all income information is entered into NCFAST correctly.
Condition: There were 5 out of 60 participants tested with various filing errors noted below. Due to theCOVID-19 Public Health Emergency, there were waivers in place during the fiscal year in which prevented the termination of benefits. In all instances, participants were found to be eligible for benefits.
Questioned costs: None.
Context: There was one instance where the approval notice was not in case file but case was properly approved; one instance where OVS was generated but not documented on the Evidence dashboard; one instance where DMA-5097 was not in the case file; one instance where income was calculated incorrectly; and one instance where checking account amount was not included in resources.
Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk that the County could not immediately substantiate the eligibility determination.
Cause: The increased workload caused by the global pandemic, coupled with Federal and State directives to not reduce or terminate benefits leading to human errors regarding clerical and data entry activities.
Recommendation: Although this issue will occur from time to time considering the volume of case files that the County processes and maintains, we recommend procedures be reinforced by means of training to ensure all proper documentation is kept and maintained.
Management’s Response: Management agrees with the finding but wishes to stress that Federal directives mandated eligibility for all applicants. Although eligibility was not affected, DSS mid-management will continue to close any continuous quality improvement process issues as well as work to improve trainings / supervision to reduce these technical errors. The results of the Single Audit will be focus areas for monthly refreshers and future trainings.
U.S. Department of Health and Human Services
Passed through the N.C. Department of Health and Human Services
Medical Assistance Programs
Assistance Listing # 93.778
Finding 2023-001
Nonmaterial Noncompliance – Eligibility
Criteria: The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NC FAST, and to ensure all required physical documentation is located in the file to properly document eligibility with program requirements. The County should ensure all countable resources are computed accurately and all income information is entered into NCFAST correctly.
Condition: There were 5 out of 60 participants tested with various filing errors noted below. Due to theCOVID-19 Public Health Emergency, there were waivers in place during the fiscal year in which prevented the termination of benefits. In all instances, participants were found to be eligible for benefits.
Questioned costs: None.
Context: There was one instance where the approval notice was not in case file but case was properly approved; one instance where OVS was generated but not documented on the Evidence dashboard; one instance where DMA-5097 was not in the case file; one instance where income was calculated incorrectly; and one instance where checking account amount was not included in resources.
Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk that the County could not immediately substantiate the eligibility determination.
Cause: The increased workload caused by the global pandemic, coupled with Federal and State directives to not reduce or terminate benefits leading to human errors regarding clerical and data entry activities.
Recommendation: Although this issue will occur from time to time considering the volume of case files that the County processes and maintains, we recommend procedures be reinforced by means of training to ensure all proper documentation is kept and maintained.
Management’s Response: Management agrees with the finding but wishes to stress that Federal directives mandated eligibility for all applicants. Although eligibility was not affected, DSS mid-management will continue to close any continuous quality improvement process issues as well as work to improve trainings / supervision to reduce these technical errors. The results of the Single Audit will be focus areas for monthly refreshers and future trainings.
U.S. Department of Health and Human Services
Passed through the N.C. Department of Health and Human Services
Medical Assistance Programs
Assistance Listing # 93.778
Finding 2023-001
Nonmaterial Noncompliance – Eligibility
Criteria: The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NC FAST, and to ensure all required physical documentation is located in the file to properly document eligibility with program requirements. The County should ensure all countable resources are computed accurately and all income information is entered into NCFAST correctly.
Condition: There were 5 out of 60 participants tested with various filing errors noted below. Due to theCOVID-19 Public Health Emergency, there were waivers in place during the fiscal year in which prevented the termination of benefits. In all instances, participants were found to be eligible for benefits.
Questioned costs: None.
Context: There was one instance where the approval notice was not in case file but case was properly approved; one instance where OVS was generated but not documented on the Evidence dashboard; one instance where DMA-5097 was not in the case file; one instance where income was calculated incorrectly; and one instance where checking account amount was not included in resources.
Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk that the County could not immediately substantiate the eligibility determination.
Cause: The increased workload caused by the global pandemic, coupled with Federal and State directives to not reduce or terminate benefits leading to human errors regarding clerical and data entry activities.
Recommendation: Although this issue will occur from time to time considering the volume of case files that the County processes and maintains, we recommend procedures be reinforced by means of training to ensure all proper documentation is kept and maintained.
Management’s Response: Management agrees with the finding but wishes to stress that Federal directives mandated eligibility for all applicants. Although eligibility was not affected, DSS mid-management will continue to close any continuous quality improvement process issues as well as work to improve trainings / supervision to reduce these technical errors. The results of the Single Audit will be focus areas for monthly refreshers and future trainings.
U.S. Department of Health and Human Services
Passed through the N.C. Department of Health and Human Services
Medical Assistance Programs
Assistance Listing # 93.778
Finding 2023-001
Nonmaterial Noncompliance – Eligibility
Criteria: The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NC FAST, and to ensure all required physical documentation is located in the file to properly document eligibility with program requirements. The County should ensure all countable resources are computed accurately and all income information is entered into NCFAST correctly.
Condition: There were 5 out of 60 participants tested with various filing errors noted below. Due to theCOVID-19 Public Health Emergency, there were waivers in place during the fiscal year in which prevented the termination of benefits. In all instances, participants were found to be eligible for benefits.
Questioned costs: None.
Context: There was one instance where the approval notice was not in case file but case was properly approved; one instance where OVS was generated but not documented on the Evidence dashboard; one instance where DMA-5097 was not in the case file; one instance where income was calculated incorrectly; and one instance where checking account amount was not included in resources.
Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk that the County could not immediately substantiate the eligibility determination.
Cause: The increased workload caused by the global pandemic, coupled with Federal and State directives to not reduce or terminate benefits leading to human errors regarding clerical and data entry activities.
Recommendation: Although this issue will occur from time to time considering the volume of case files that the County processes and maintains, we recommend procedures be reinforced by means of training to ensure all proper documentation is kept and maintained.
Management’s Response: Management agrees with the finding but wishes to stress that Federal directives mandated eligibility for all applicants. Although eligibility was not affected, DSS mid-management will continue to close any continuous quality improvement process issues as well as work to improve trainings / supervision to reduce these technical errors. The results of the Single Audit will be focus areas for monthly refreshers and future trainings.
U.S. Department of Health and Human Services
Passed through the N.C. Department of Health and Human Services
Medical Assistance Programs
Assistance Listing # 93.778
Finding 2023-001
Nonmaterial Noncompliance – Eligibility
Criteria: The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NC FAST, and to ensure all required physical documentation is located in the file to properly document eligibility with program requirements. The County should ensure all countable resources are computed accurately and all income information is entered into NCFAST correctly.
Condition: There were 5 out of 60 participants tested with various filing errors noted below. Due to theCOVID-19 Public Health Emergency, there were waivers in place during the fiscal year in which prevented the termination of benefits. In all instances, participants were found to be eligible for benefits.
Questioned costs: None.
Context: There was one instance where the approval notice was not in case file but case was properly approved; one instance where OVS was generated but not documented on the Evidence dashboard; one instance where DMA-5097 was not in the case file; one instance where income was calculated incorrectly; and one instance where checking account amount was not included in resources.
Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk that the County could not immediately substantiate the eligibility determination.
Cause: The increased workload caused by the global pandemic, coupled with Federal and State directives to not reduce or terminate benefits leading to human errors regarding clerical and data entry activities.
Recommendation: Although this issue will occur from time to time considering the volume of case files that the County processes and maintains, we recommend procedures be reinforced by means of training to ensure all proper documentation is kept and maintained.
Management’s Response: Management agrees with the finding but wishes to stress that Federal directives mandated eligibility for all applicants. Although eligibility was not affected, DSS mid-management will continue to close any continuous quality improvement process issues as well as work to improve trainings / supervision to reduce these technical errors. The results of the Single Audit will be focus areas for monthly refreshers and future trainings.
U.S. Department of Health and Human Services
Passed through the N.C. Department of Health and Human Services
Medical Assistance Programs
Assistance Listing # 93.778
Finding 2023-001
Nonmaterial Noncompliance – Eligibility
Criteria: The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NC FAST, and to ensure all required physical documentation is located in the file to properly document eligibility with program requirements. The County should ensure all countable resources are computed accurately and all income information is entered into NCFAST correctly.
Condition: There were 5 out of 60 participants tested with various filing errors noted below. Due to theCOVID-19 Public Health Emergency, there were waivers in place during the fiscal year in which prevented the termination of benefits. In all instances, participants were found to be eligible for benefits.
Questioned costs: None.
Context: There was one instance where the approval notice was not in case file but case was properly approved; one instance where OVS was generated but not documented on the Evidence dashboard; one instance where DMA-5097 was not in the case file; one instance where income was calculated incorrectly; and one instance where checking account amount was not included in resources.
Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk that the County could not immediately substantiate the eligibility determination.
Cause: The increased workload caused by the global pandemic, coupled with Federal and State directives to not reduce or terminate benefits leading to human errors regarding clerical and data entry activities.
Recommendation: Although this issue will occur from time to time considering the volume of case files that the County processes and maintains, we recommend procedures be reinforced by means of training to ensure all proper documentation is kept and maintained.
Management’s Response: Management agrees with the finding but wishes to stress that Federal directives mandated eligibility for all applicants. Although eligibility was not affected, DSS mid-management will continue to close any continuous quality improvement process issues as well as work to improve trainings / supervision to reduce these technical errors. The results of the Single Audit will be focus areas for monthly refreshers and future trainings.
U.S. Department of Health and Human Services
Passed through the N.C. Department of Health and Human Services
Medical Assistance Programs
Assistance Listing # 93.778
Finding 2023-001
Nonmaterial Noncompliance – Eligibility
Criteria: The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NC FAST, and to ensure all required physical documentation is located in the file to properly document eligibility with program requirements. The County should ensure all countable resources are computed accurately and all income information is entered into NCFAST correctly.
Condition: There were 5 out of 60 participants tested with various filing errors noted below. Due to theCOVID-19 Public Health Emergency, there were waivers in place during the fiscal year in which prevented the termination of benefits. In all instances, participants were found to be eligible for benefits.
Questioned costs: None.
Context: There was one instance where the approval notice was not in case file but case was properly approved; one instance where OVS was generated but not documented on the Evidence dashboard; one instance where DMA-5097 was not in the case file; one instance where income was calculated incorrectly; and one instance where checking account amount was not included in resources.
Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk that the County could not immediately substantiate the eligibility determination.
Cause: The increased workload caused by the global pandemic, coupled with Federal and State directives to not reduce or terminate benefits leading to human errors regarding clerical and data entry activities.
Recommendation: Although this issue will occur from time to time considering the volume of case files that the County processes and maintains, we recommend procedures be reinforced by means of training to ensure all proper documentation is kept and maintained.
Management’s Response: Management agrees with the finding but wishes to stress that Federal directives mandated eligibility for all applicants. Although eligibility was not affected, DSS mid-management will continue to close any continuous quality improvement process issues as well as work to improve trainings / supervision to reduce these technical errors. The results of the Single Audit will be focus areas for monthly refreshers and future trainings.
U.S. Department of Health and Human Services
Passed through the N.C. Department of Health and Human Services
Medical Assistance Programs
Assistance Listing # 93.778
Finding 2023-001
Nonmaterial Noncompliance – Eligibility
Criteria: The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NC FAST, and to ensure all required physical documentation is located in the file to properly document eligibility with program requirements. The County should ensure all countable resources are computed accurately and all income information is entered into NCFAST correctly.
Condition: There were 5 out of 60 participants tested with various filing errors noted below. Due to theCOVID-19 Public Health Emergency, there were waivers in place during the fiscal year in which prevented the termination of benefits. In all instances, participants were found to be eligible for benefits.
Questioned costs: None.
Context: There was one instance where the approval notice was not in case file but case was properly approved; one instance where OVS was generated but not documented on the Evidence dashboard; one instance where DMA-5097 was not in the case file; one instance where income was calculated incorrectly; and one instance where checking account amount was not included in resources.
Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk that the County could not immediately substantiate the eligibility determination.
Cause: The increased workload caused by the global pandemic, coupled with Federal and State directives to not reduce or terminate benefits leading to human errors regarding clerical and data entry activities.
Recommendation: Although this issue will occur from time to time considering the volume of case files that the County processes and maintains, we recommend procedures be reinforced by means of training to ensure all proper documentation is kept and maintained.
Management’s Response: Management agrees with the finding but wishes to stress that Federal directives mandated eligibility for all applicants. Although eligibility was not affected, DSS mid-management will continue to close any continuous quality improvement process issues as well as work to improve trainings / supervision to reduce these technical errors. The results of the Single Audit will be focus areas for monthly refreshers and future trainings.
U.S. Department of Health and Human Services
Passed through the N.C. Department of Health and Human Services
Medical Assistance Programs
Assistance Listing # 93.778
Finding 2023-001
Nonmaterial Noncompliance – Eligibility
Criteria: The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NC FAST, and to ensure all required physical documentation is located in the file to properly document eligibility with program requirements. The County should ensure all countable resources are computed accurately and all income information is entered into NCFAST correctly.
Condition: There were 5 out of 60 participants tested with various filing errors noted below. Due to theCOVID-19 Public Health Emergency, there were waivers in place during the fiscal year in which prevented the termination of benefits. In all instances, participants were found to be eligible for benefits.
Questioned costs: None.
Context: There was one instance where the approval notice was not in case file but case was properly approved; one instance where OVS was generated but not documented on the Evidence dashboard; one instance where DMA-5097 was not in the case file; one instance where income was calculated incorrectly; and one instance where checking account amount was not included in resources.
Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk that the County could not immediately substantiate the eligibility determination.
Cause: The increased workload caused by the global pandemic, coupled with Federal and State directives to not reduce or terminate benefits leading to human errors regarding clerical and data entry activities.
Recommendation: Although this issue will occur from time to time considering the volume of case files that the County processes and maintains, we recommend procedures be reinforced by means of training to ensure all proper documentation is kept and maintained.
Management’s Response: Management agrees with the finding but wishes to stress that Federal directives mandated eligibility for all applicants. Although eligibility was not affected, DSS mid-management will continue to close any continuous quality improvement process issues as well as work to improve trainings / supervision to reduce these technical errors. The results of the Single Audit will be focus areas for monthly refreshers and future trainings.