Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance Program (Medicaid Cluster)
Assistance Listing Number: 93.778
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2305MN5ADM, 2305MN5MAP
Federal Award Identification Number and Year: 2305MN5ADM, 2305MN5MAP, 2023
Compliance Requirement Affected: Eligibility
Award Period: Year Ended December 31, 2023
Type of Finding: Material Weakness in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements and correctly determining program eligibility.
Condition: There was no formal review documented over internal case files worked by program eligibility specialists.
Questioned Costs: None
Context: During our testing of eligibility and testing of case file reviews completed during 2023 for Medical Assistance, it was noted that there were no documented case file reviews performed.
Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight.
Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible.
Repeat Finding: Yes, 2022-007.
Recommendation: We recommend that the County review case files on a periodic basis throughout the year and document the review.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance Program (Medicaid Cluster)
Assistance Listing Number: 93.778
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2305MN5ADM, 2305MN5MAP
Federal Award Identification Number and Year: 2305MN5ADM, 2305MN5MAP, 2023
Compliance Requirement Affected: Eligibility
Award Period: Year Ended December 31, 2023
Type of Finding: Material Weakness in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements and correctly determining program eligibility.
Condition: There was no formal review documented over internal case files worked by program eligibility specialists.
Questioned Costs: None
Context: During our testing of eligibility and testing of case file reviews completed during 2023 for Medical Assistance, it was noted that there were no documented case file reviews performed.
Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight.
Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible.
Repeat Finding: Yes, 2022-007.
Recommendation: We recommend that the County review case files on a periodic basis throughout the year and document the review.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance Program (Medicaid Cluster)
Assistance Listing Number: 93.778
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2305MN5ADM, 2305MN5MAP
Federal Award Identification Number and Year: 2305MN5ADM, 2305MN5MAP, 2023
Compliance Requirement Affected: Eligibility
Award Period: Year Ended December 31, 2023
Type of Finding: Material Weakness in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements and correctly determining program eligibility.
Condition: There was no formal review documented over internal case files worked by program eligibility specialists.
Questioned Costs: None
Context: During our testing of eligibility and testing of case file reviews completed during 2023 for Medical Assistance, it was noted that there were no documented case file reviews performed.
Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight.
Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible.
Repeat Finding: Yes, 2022-007.
Recommendation: We recommend that the County review case files on a periodic basis throughout the year and document the review.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance Program (Medicaid Cluster)
Assistance Listing Number: 93.778
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2305MN5ADM, 2305MN5MAP
Federal Award Identification Number and Year: 2305MN5ADM, 2305MN5MAP, 2023
Compliance Requirement Affected: Reporting
Award Period: Year Ended December 31, 2023
Type of Finding: Significant Deficiency in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend that reports should have a review documented by someone other than the preparer.
Condition: The County’s annual LCTS collaborative report filed was missing documentation of review by someone other than the preparer.
Questioned Costs: None
Context: During our testing of the annual LCTS collaborative report, it was noted that the annual report was missing documentation of review by someone other than the preparer.
Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight.
Effect: Reports could be prepared with errors that are not corrected prior to submission.
Repeat Finding: No
Recommendation: We recommend that the County ensured each report is reviewed by someone other than the preparer.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance Program (Medicaid Cluster)
Assistance Listing Number: 93.778
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2305MN5ADM, 2305MN5MAP
Federal Award Identification Number and Year: 2305MN5ADM, 2305MN5MAP, 2023
Compliance Requirement Affected: Reporting
Award Period: Year Ended December 31, 2023
Type of Finding: Significant Deficiency in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend that reports should have a review documented by someone other than the preparer.
Condition: The County’s annual LCTS collaborative report filed was missing documentation of review by someone other than the preparer.
Questioned Costs: None
Context: During our testing of the annual LCTS collaborative report, it was noted that the annual report was missing documentation of review by someone other than the preparer.
Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight.
Effect: Reports could be prepared with errors that are not corrected prior to submission.
Repeat Finding: No
Recommendation: We recommend that the County ensured each report is reviewed by someone other than the preparer.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance Program (Medicaid Cluster)
Assistance Listing Number: 93.778
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2305MN5ADM, 2305MN5MAP
Federal Award Identification Number and Year: 2305MN5ADM, 2305MN5MAP, 2023
Compliance Requirement Affected: Reporting
Award Period: Year Ended December 31, 2023
Type of Finding: Significant Deficiency in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend that reports should have a review documented by someone other than the preparer.
Condition: The County’s annual LCTS collaborative report filed was missing documentation of review by someone other than the preparer.
Questioned Costs: None
Context: During our testing of the annual LCTS collaborative report, it was noted that the annual report was missing documentation of review by someone other than the preparer.
Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight.
Effect: Reports could be prepared with errors that are not corrected prior to submission.
Repeat Finding: No
Recommendation: We recommend that the County ensured each report is reviewed by someone other than the preparer.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Temporary Assistance for Needy Families (TANF)
Assistance Listing Number: 93.558
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2301MNTANF
Federal Award Identification Number and Year: 2301MNTANF, 2023
Compliance Requirement Affected: Eligibility
Award Period: Year Ended December 31, 2023
Type of Finding: Material Weakness in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements.
Condition: There was no formal review documented over internal case files worked by program eligibility specialists.
Questioned Costs: None
Context: During our testing of case file reviews during 2023, it was noted that there were no documented case file reviews performed for the human services component of Temporary Assistance for Needy Families.
Cause: The Minnesota Department of Human Services is not requiring a review of case files and lack of management oversight.
Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible.
Repeat Finding: Yes, 2022-008.
Recommendation: We recommend that the County review case files on a periodic basis throughout the year.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Temporary Assistance for Needy Families (TANF)
Assistance Listing Number: 93.558
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2301MNTANF
Federal Award Identification Number and Year: 2301MNTANF, 2023
Compliance Requirement Affected: Eligibility
Award Period: Year Ended December 31, 2023
Type of Finding: Material Weakness in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements.
Condition: There was no formal review documented over internal case files worked by program eligibility specialists.
Questioned Costs: None
Context: During our testing of case file reviews during 2023, it was noted that there were no documented case file reviews performed for the human services component of Temporary Assistance for Needy Families.
Cause: The Minnesota Department of Human Services is not requiring a review of case files and lack of management oversight.
Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible.
Repeat Finding: Yes, 2022-008.
Recommendation: We recommend that the County review case files on a periodic basis throughout the year.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance Program (Medicaid Cluster)
Assistance Listing Number: 93.778
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2305MN5ADM, 2305MN5MAP
Federal Award Identification Number and Year: 2305MN5ADM, 2305MN5MAP, 2023
Compliance Requirement Affected: Eligibility
Award Period: Year Ended December 31, 2023
Type of Finding: Material Weakness in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements and correctly determining program eligibility.
Condition: There was no formal review documented over internal case files worked by program eligibility specialists.
Questioned Costs: None
Context: During our testing of eligibility and testing of case file reviews completed during 2023 for Medical Assistance, it was noted that there were no documented case file reviews performed.
Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight.
Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible.
Repeat Finding: Yes, 2022-007.
Recommendation: We recommend that the County review case files on a periodic basis throughout the year and document the review.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance Program (Medicaid Cluster)
Assistance Listing Number: 93.778
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2305MN5ADM, 2305MN5MAP
Federal Award Identification Number and Year: 2305MN5ADM, 2305MN5MAP, 2023
Compliance Requirement Affected: Eligibility
Award Period: Year Ended December 31, 2023
Type of Finding: Material Weakness in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements and correctly determining program eligibility.
Condition: There was no formal review documented over internal case files worked by program eligibility specialists.
Questioned Costs: None
Context: During our testing of eligibility and testing of case file reviews completed during 2023 for Medical Assistance, it was noted that there were no documented case file reviews performed.
Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight.
Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible.
Repeat Finding: Yes, 2022-007.
Recommendation: We recommend that the County review case files on a periodic basis throughout the year and document the review.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance Program (Medicaid Cluster)
Assistance Listing Number: 93.778
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2305MN5ADM, 2305MN5MAP
Federal Award Identification Number and Year: 2305MN5ADM, 2305MN5MAP, 2023
Compliance Requirement Affected: Eligibility
Award Period: Year Ended December 31, 2023
Type of Finding: Material Weakness in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements and correctly determining program eligibility.
Condition: There was no formal review documented over internal case files worked by program eligibility specialists.
Questioned Costs: None
Context: During our testing of eligibility and testing of case file reviews completed during 2023 for Medical Assistance, it was noted that there were no documented case file reviews performed.
Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight.
Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible.
Repeat Finding: Yes, 2022-007.
Recommendation: We recommend that the County review case files on a periodic basis throughout the year and document the review.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance Program (Medicaid Cluster)
Assistance Listing Number: 93.778
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2305MN5ADM, 2305MN5MAP
Federal Award Identification Number and Year: 2305MN5ADM, 2305MN5MAP, 2023
Compliance Requirement Affected: Reporting
Award Period: Year Ended December 31, 2023
Type of Finding: Significant Deficiency in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend that reports should have a review documented by someone other than the preparer.
Condition: The County’s annual LCTS collaborative report filed was missing documentation of review by someone other than the preparer.
Questioned Costs: None
Context: During our testing of the annual LCTS collaborative report, it was noted that the annual report was missing documentation of review by someone other than the preparer.
Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight.
Effect: Reports could be prepared with errors that are not corrected prior to submission.
Repeat Finding: No
Recommendation: We recommend that the County ensured each report is reviewed by someone other than the preparer.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance Program (Medicaid Cluster)
Assistance Listing Number: 93.778
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2305MN5ADM, 2305MN5MAP
Federal Award Identification Number and Year: 2305MN5ADM, 2305MN5MAP, 2023
Compliance Requirement Affected: Reporting
Award Period: Year Ended December 31, 2023
Type of Finding: Significant Deficiency in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend that reports should have a review documented by someone other than the preparer.
Condition: The County’s annual LCTS collaborative report filed was missing documentation of review by someone other than the preparer.
Questioned Costs: None
Context: During our testing of the annual LCTS collaborative report, it was noted that the annual report was missing documentation of review by someone other than the preparer.
Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight.
Effect: Reports could be prepared with errors that are not corrected prior to submission.
Repeat Finding: No
Recommendation: We recommend that the County ensured each report is reviewed by someone other than the preparer.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance Program (Medicaid Cluster)
Assistance Listing Number: 93.778
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2305MN5ADM, 2305MN5MAP
Federal Award Identification Number and Year: 2305MN5ADM, 2305MN5MAP, 2023
Compliance Requirement Affected: Reporting
Award Period: Year Ended December 31, 2023
Type of Finding: Significant Deficiency in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend that reports should have a review documented by someone other than the preparer.
Condition: The County’s annual LCTS collaborative report filed was missing documentation of review by someone other than the preparer.
Questioned Costs: None
Context: During our testing of the annual LCTS collaborative report, it was noted that the annual report was missing documentation of review by someone other than the preparer.
Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight.
Effect: Reports could be prepared with errors that are not corrected prior to submission.
Repeat Finding: No
Recommendation: We recommend that the County ensured each report is reviewed by someone other than the preparer.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Temporary Assistance for Needy Families (TANF)
Assistance Listing Number: 93.558
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2301MNTANF
Federal Award Identification Number and Year: 2301MNTANF, 2023
Compliance Requirement Affected: Eligibility
Award Period: Year Ended December 31, 2023
Type of Finding: Material Weakness in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements.
Condition: There was no formal review documented over internal case files worked by program eligibility specialists.
Questioned Costs: None
Context: During our testing of case file reviews during 2023, it was noted that there were no documented case file reviews performed for the human services component of Temporary Assistance for Needy Families.
Cause: The Minnesota Department of Human Services is not requiring a review of case files and lack of management oversight.
Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible.
Repeat Finding: Yes, 2022-008.
Recommendation: We recommend that the County review case files on a periodic basis throughout the year.
Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Temporary Assistance for Needy Families (TANF)
Assistance Listing Number: 93.558
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching
Community Health Board
Pass-Through Numbers: 2301MNTANF
Federal Award Identification Number and Year: 2301MNTANF, 2023
Compliance Requirement Affected: Eligibility
Award Period: Year Ended December 31, 2023
Type of Finding: Material Weakness in Internal Control Over Compliance
Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements.
Condition: There was no formal review documented over internal case files worked by program eligibility specialists.
Questioned Costs: None
Context: During our testing of case file reviews during 2023, it was noted that there were no documented case file reviews performed for the human services component of Temporary Assistance for Needy Families.
Cause: The Minnesota Department of Human Services is not requiring a review of case files and lack of management oversight.
Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible.
Repeat Finding: Yes, 2022-008.
Recommendation: We recommend that the County review case files on a periodic basis throughout the year.
Views of Responsible Officials: There is no disagreement with the audit finding.