Finding: 2022-007 U.S. Department of Agriculture Passed through the N.C. Department of Health and Human Services Program Name: Supplemental Nutrition Assistance Program Cluster AL #: 10.561 Internal Control, Significant Deficiency Criteria: Counties must acquire adequate case documentation to substantiate the claim entry into the Enterprise Program Integrity (EPI). This documentation includes proper use of standardized Form 1682. Condition: EPI casefile did not include a signed Form 1682. Context: This compliance requirement falls under DSS Crosscutting Requirements by the N.C. Department of Health and Human Services. The EPI system was implemented to track and collect overpayments in various programs under the Division of Social Services. The program under which the case error was noted for the County was Food and Nutrition Services Program (Food Stamps). Effect: Claims can be incorrectly reported into EPI. Cause: Turnover in supervisor position left duties unfulfilled and an unsigned Form 1682 in the case file. Questioned Costs: The finding represents an internal control weakness; therefore, no questioned costs are applicable. Upon further review, the case was still eligible to report a claim entry into EPI. Recommendation: The County should have procedures in place to cover the review process upon turnover within department. Views of Responsible Officials and Planned Corrective Actions: See Corrective Action Plan submitted with this report.
Finding: 2022-007 U.S. Department of Agriculture Passed through the N.C. Department of Health and Human Services Program Name: Supplemental Nutrition Assistance Program Cluster AL #: 10.561 Internal Control, Significant Deficiency Criteria: Counties must acquire adequate case documentation to substantiate the claim entry into the Enterprise Program Integrity (EPI). This documentation includes proper use of standardized Form 1682. Condition: EPI casefile did not include a signed Form 1682. Context: This compliance requirement falls under DSS Crosscutting Requirements by the N.C. Department of Health and Human Services. The EPI system was implemented to track and collect overpayments in various programs under the Division of Social Services. The program under which the case error was noted for the County was Food and Nutrition Services Program (Food Stamps). Effect: Claims can be incorrectly reported into EPI. Cause: Turnover in supervisor position left duties unfulfilled and an unsigned Form 1682 in the case file. Questioned Costs: The finding represents an internal control weakness; therefore, no questioned costs are applicable. Upon further review, the case was still eligible to report a claim entry into EPI. Recommendation: The County should have procedures in place to cover the review process upon turnover within department. Views of Responsible Officials and Planned Corrective Actions: See Corrective Action Plan submitted with this report.
Finding: 2022-005 U.S. Department of Health and Human Services Passed-through N.C. Department of Health and Human Services Program Name: Temporary Assistance for Needed Families AL #: 93.558 Internal Control, Significant Deficiency Criteria: The County policies require the department to conduct second-party reviews as part of the system of quality control. Management should have adequate second-party review procedures in place to properly review and assess the eligibility of individuals in order to ensure that the benefits being provided are within program requirements and documentation in the case file is complete and accurate. Evidence of review should be documented and be for the entire year. Condition: Process for second party reviews did not take place throughout the entire fiscal year. Context: Supervisors did not complete second party reviews throughout the entire fiscal year for the Temporary Assistance for Needed Families program. Effect: The County?s second-party review process is not effective at ensuring that case files are complete and accurate. Errors could exist that go uncorrected. Cause: Turnover in department left certain duties unfulfilled during part of the fiscal year. Questioned Cost: The finding represents an internal control weakness; therefore, no questioned costs are applicable. Recommendation: The County should have procedures in place to cover the second-party review process upon turnover within department. Views of Responsible Officials and Planned Corrective Action: See Corrective Action Plan submitted with this report.
Finding: 2022-005 U.S. Department of Health and Human Services Passed-through N.C. Department of Health and Human Services Program Name: Temporary Assistance for Needed Families AL #: 93.558 Internal Control, Significant Deficiency Criteria: The County policies require the department to conduct second-party reviews as part of the system of quality control. Management should have adequate second-party review procedures in place to properly review and assess the eligibility of individuals in order to ensure that the benefits being provided are within program requirements and documentation in the case file is complete and accurate. Evidence of review should be documented and be for the entire year. Condition: Process for second party reviews did not take place throughout the entire fiscal year. Context: Supervisors did not complete second party reviews throughout the entire fiscal year for the Temporary Assistance for Needed Families program. Effect: The County?s second-party review process is not effective at ensuring that case files are complete and accurate. Errors could exist that go uncorrected. Cause: Turnover in department left certain duties unfulfilled during part of the fiscal year. Questioned Cost: The finding represents an internal control weakness; therefore, no questioned costs are applicable. Recommendation: The County should have procedures in place to cover the second-party review process upon turnover within department. Views of Responsible Officials and Planned Corrective Action: See Corrective Action Plan submitted with this report.
Finding: 2022-006 U.S. Department of Health and Human Services Passed through the N.C. Department of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) AL #: 93.778 Internal Control, Significant Deficiency Criteria: In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a recipient meets specific eligibility standards, and documentation must be maintained to support those determinations. In accordance with 2 CFR 200, management should have an adequate system of internal control procedures in place to ensure the accuracy of benefits being provided is within program requirements. Management must monitor activities under federal awards to assure compliance with federal requirements. Condition: One casefile had income documented in NC FAST that did not match supporting source document (AVS). After review of the cases, the participant was found to still be eligible for Medicaid benefits. Context: Of the 1,159,466 benefit payment cases valued at $357,644,529, we examined 60 payment records ($11,247 value) and determined that the above condition to one payment (.15% valued at $17). We determined that the participant was still eligible after redetermination with the correct documentation. Effect: Participants could receive benefits for which they are not eligible. Cause: Caseworkers did not take proper steps in making sure what was used for eligibility determination was complete and accurate per program guidelines. Questioned Costs: The finding represents an internal control weakness; therefore, no questioned costs are applicable. Upon further review, the applicant was still eligible to receive Medicaid benefits. Recommendation: Caseworkers should review their eligibility determinations and ensure all documentation is included and accurate. Views of Responsible Officials and Planned Corrective Action: See Corrective Action Plan submitted with this report.
Finding: 2022-007 U.S. Department of Agriculture Passed through the N.C. Department of Health and Human Services Program Name: Supplemental Nutrition Assistance Program Cluster AL #: 10.561 Internal Control, Significant Deficiency Criteria: Counties must acquire adequate case documentation to substantiate the claim entry into the Enterprise Program Integrity (EPI). This documentation includes proper use of standardized Form 1682. Condition: EPI casefile did not include a signed Form 1682. Context: This compliance requirement falls under DSS Crosscutting Requirements by the N.C. Department of Health and Human Services. The EPI system was implemented to track and collect overpayments in various programs under the Division of Social Services. The program under which the case error was noted for the County was Food and Nutrition Services Program (Food Stamps). Effect: Claims can be incorrectly reported into EPI. Cause: Turnover in supervisor position left duties unfulfilled and an unsigned Form 1682 in the case file. Questioned Costs: The finding represents an internal control weakness; therefore, no questioned costs are applicable. Upon further review, the case was still eligible to report a claim entry into EPI. Recommendation: The County should have procedures in place to cover the review process upon turnover within department. Views of Responsible Officials and Planned Corrective Actions: See Corrective Action Plan submitted with this report.
Finding: 2022-007 U.S. Department of Agriculture Passed through the N.C. Department of Health and Human Services Program Name: Supplemental Nutrition Assistance Program Cluster AL #: 10.561 Internal Control, Significant Deficiency Criteria: Counties must acquire adequate case documentation to substantiate the claim entry into the Enterprise Program Integrity (EPI). This documentation includes proper use of standardized Form 1682. Condition: EPI casefile did not include a signed Form 1682. Context: This compliance requirement falls under DSS Crosscutting Requirements by the N.C. Department of Health and Human Services. The EPI system was implemented to track and collect overpayments in various programs under the Division of Social Services. The program under which the case error was noted for the County was Food and Nutrition Services Program (Food Stamps). Effect: Claims can be incorrectly reported into EPI. Cause: Turnover in supervisor position left duties unfulfilled and an unsigned Form 1682 in the case file. Questioned Costs: The finding represents an internal control weakness; therefore, no questioned costs are applicable. Upon further review, the case was still eligible to report a claim entry into EPI. Recommendation: The County should have procedures in place to cover the review process upon turnover within department. Views of Responsible Officials and Planned Corrective Actions: See Corrective Action Plan submitted with this report.
Finding: 2022-005 U.S. Department of Health and Human Services Passed-through N.C. Department of Health and Human Services Program Name: Temporary Assistance for Needed Families AL #: 93.558 Internal Control, Significant Deficiency Criteria: The County policies require the department to conduct second-party reviews as part of the system of quality control. Management should have adequate second-party review procedures in place to properly review and assess the eligibility of individuals in order to ensure that the benefits being provided are within program requirements and documentation in the case file is complete and accurate. Evidence of review should be documented and be for the entire year. Condition: Process for second party reviews did not take place throughout the entire fiscal year. Context: Supervisors did not complete second party reviews throughout the entire fiscal year for the Temporary Assistance for Needed Families program. Effect: The County?s second-party review process is not effective at ensuring that case files are complete and accurate. Errors could exist that go uncorrected. Cause: Turnover in department left certain duties unfulfilled during part of the fiscal year. Questioned Cost: The finding represents an internal control weakness; therefore, no questioned costs are applicable. Recommendation: The County should have procedures in place to cover the second-party review process upon turnover within department. Views of Responsible Officials and Planned Corrective Action: See Corrective Action Plan submitted with this report.
Finding: 2022-005 U.S. Department of Health and Human Services Passed-through N.C. Department of Health and Human Services Program Name: Temporary Assistance for Needed Families AL #: 93.558 Internal Control, Significant Deficiency Criteria: The County policies require the department to conduct second-party reviews as part of the system of quality control. Management should have adequate second-party review procedures in place to properly review and assess the eligibility of individuals in order to ensure that the benefits being provided are within program requirements and documentation in the case file is complete and accurate. Evidence of review should be documented and be for the entire year. Condition: Process for second party reviews did not take place throughout the entire fiscal year. Context: Supervisors did not complete second party reviews throughout the entire fiscal year for the Temporary Assistance for Needed Families program. Effect: The County?s second-party review process is not effective at ensuring that case files are complete and accurate. Errors could exist that go uncorrected. Cause: Turnover in department left certain duties unfulfilled during part of the fiscal year. Questioned Cost: The finding represents an internal control weakness; therefore, no questioned costs are applicable. Recommendation: The County should have procedures in place to cover the second-party review process upon turnover within department. Views of Responsible Officials and Planned Corrective Action: See Corrective Action Plan submitted with this report.
Finding: 2022-006 U.S. Department of Health and Human Services Passed through the N.C. Department of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) AL #: 93.778 Internal Control, Significant Deficiency Criteria: In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a recipient meets specific eligibility standards, and documentation must be maintained to support those determinations. In accordance with 2 CFR 200, management should have an adequate system of internal control procedures in place to ensure the accuracy of benefits being provided is within program requirements. Management must monitor activities under federal awards to assure compliance with federal requirements. Condition: One casefile had income documented in NC FAST that did not match supporting source document (AVS). After review of the cases, the participant was found to still be eligible for Medicaid benefits. Context: Of the 1,159,466 benefit payment cases valued at $357,644,529, we examined 60 payment records ($11,247 value) and determined that the above condition to one payment (.15% valued at $17). We determined that the participant was still eligible after redetermination with the correct documentation. Effect: Participants could receive benefits for which they are not eligible. Cause: Caseworkers did not take proper steps in making sure what was used for eligibility determination was complete and accurate per program guidelines. Questioned Costs: The finding represents an internal control weakness; therefore, no questioned costs are applicable. Upon further review, the applicant was still eligible to receive Medicaid benefits. Recommendation: Caseworkers should review their eligibility determinations and ensure all documentation is included and accurate. Views of Responsible Officials and Planned Corrective Action: See Corrective Action Plan submitted with this report.