FAC Explorer

Audit 305278

FY End
2023-12-31
Total Expended
$63.48M
Findings
2
Programs
1
Organization: Maine Guaranteed Access Reinsurance Association (ME)
Year: 2023 Accepted: 2024-05-01
Auditor: Eide Bailly LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
395648 2023-002 Significant Deficiency - AB
972090 2023-002 Significant Deficiency - AB

Programs

ALN Program Spent Major Findings
93.423 State Innovation Waivers $63.48M Yes 1

Contacts

Name Title Type
YMJKWKQM6XC6 Laren Walker Auditee
2087948840 Jodi Daugherty Auditor
No contacts on file

Notes to SEFA

Title: NOTE 1 - BASIS OF PRESENTATION Accounting Policies: Expenditures reported in the schedule are reported on the accrual basis of accounting. When applicable, such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The Association does not draw for indirect administrative expenses and has not elected to use the 10% de minimis cost rate. The accompanying schedule of expenditures of federal awards (the schedule) includes the federal award activity of the Maine Guaranteed Access Reinsurance Association (the Association) under programs of the federal government for the year ended December 31, 2023. The information is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the schedule presents only a selected portion of the operations of the Association, it is not intended to and does not present the financial position, changes in net position, or cash flows of the Association.
Title: NOTE 2 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Accounting Policies: Expenditures reported in the schedule are reported on the accrual basis of accounting. When applicable, such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The Association does not draw for indirect administrative expenses and has not elected to use the 10% de minimis cost rate. Expenditures reported in the schedule are reported on the accrual basis of accounting. When applicable, such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. No federal financial assistance has been provided to a subrecipient.
Title: NOTE 3 - INDIRECT COST RATE Accounting Policies: Expenditures reported in the schedule are reported on the accrual basis of accounting. When applicable, such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The Association does not draw for indirect administrative expenses and has not elected to use the 10% de minimis cost rate. The Association does not draw for indirect administrative expenses and has not elected to use the 10% de minimis cost rate.

Finding Details

Finding 2023-002
U.S. Department of Health and Human Services Federal Financial Assistance Listing 93.423 1332 State Innovation Waivers Activities Allowed or Unallowed and Allowable Costs/Cost Principles Significant Deficiency in Internal Control in Federal Compliance Criteria: Costs charged to the federal funds under the 1332 Waiver program must comply with the cost principles at 45 CFR Part 75, Subpart E, and any other requirements or restrictions on the use of federal funding outlined in the grant Standard Terms and Conditions. Condition: The Association’s existing controls over their IT environment for reviewing and reimbursing carriers for claims was not able to detect and prevent a claim from being reimbursed twice. Cause: The Association began working with a new carrier, Aetna, and did not modify their IT environment for this specific carrier to ensure that claims being reimbursed were not able to be duplicated. Effect: A claim was able to be reimbursed to a carrier twice using federal monies. Questioned Costs: $74,799.52 Context/Sampling: A nonstatistical sample of 60 claims out of 89,552 claims were selected for testing. Repeat Finding from Prior Year(s): No Recommendation: Management should implement parameters in their IT environment that allow them the ability to detect and prevent a claim being duplicated and paid out twice. Views of Responsible Officials: Management of the Association agrees with the finding.
Finding 2023-002
U.S. Department of Health and Human Services Federal Financial Assistance Listing 93.423 1332 State Innovation Waivers Activities Allowed or Unallowed and Allowable Costs/Cost Principles Significant Deficiency in Internal Control in Federal Compliance Criteria: Costs charged to the federal funds under the 1332 Waiver program must comply with the cost principles at 45 CFR Part 75, Subpart E, and any other requirements or restrictions on the use of federal funding outlined in the grant Standard Terms and Conditions. Condition: The Association’s existing controls over their IT environment for reviewing and reimbursing carriers for claims was not able to detect and prevent a claim from being reimbursed twice. Cause: The Association began working with a new carrier, Aetna, and did not modify their IT environment for this specific carrier to ensure that claims being reimbursed were not able to be duplicated. Effect: A claim was able to be reimbursed to a carrier twice using federal monies. Questioned Costs: $74,799.52 Context/Sampling: A nonstatistical sample of 60 claims out of 89,552 claims were selected for testing. Repeat Finding from Prior Year(s): No Recommendation: Management should implement parameters in their IT environment that allow them the ability to detect and prevent a claim being duplicated and paid out twice. Views of Responsible Officials: Management of the Association agrees with the finding.