U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL #: 93.778
Finding: 2024-001 Inaccurate Information Entry
SIGNIFICANT DEFICENCY
ELIGIBILITY
Criteria:
Section III. Federal Award Findings and Questioned Costs
Section I. Summary of Auditors' Results (continued)
Section II. Financial Statement Findings
Type of auditors' report issued on compliance for major State programs:
In accordance with 42 CFR 435, documentation must be obtained as needed to
determine if a recipient meets specific standards, and documentation must be
maintained to support eligibility determinations. In accordance with 2 CFR 200,
management should have an adequate system of internal controls procedures in place to
ensure an applicant is properly determined or redetermined for benefits.
Condition:
Questioned Costs:
Context:
Effect:
Identification of a
repeat finding:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL #: 93.778
Finding: 2024-002 Inadequate Request For Information
SIGNIFICANT DEFICENCY
ELIGIBILITY
Criteria:
Section III. Federal Award Findings and Questioned Costs (continued)
There were 7 errors discovered during our procedures where income or household size
was incorrectly calculated or inaccurate information was entered into the case file.
There was no known affect to eligibility and there were no known questioned costs.
We examined 60 cases from of a total of 1,176,385 Medicaid claims from the Medicaid
beneficiary report provided by NC Department of Health and Human Services to redetermine
eligibility. These findings are being reported with the financial statement audit
as it relates to Medicaid administrative cost compliance audit.
For those certifications/re-certifications there was a chance that information was not
properly documented and reconciled to NC FAST and a participant could have been
approved for benefits for which they were not eligible.
Ineffective record keeping and ineffective case review process, incomplete
documentation, and incorrect application of rules for purposes of determining eligibility.
Files should be reviewed internally to ensure proper documentation is in place for
eligibility. Workers should be retrained on what files should contain and the importance
of complete and accurate record keeping. We recommend that all files include online
verifications, documented resources of income and those amounts agree to information
in NC FAST. The results found or documentation made in case notes should clearly
indicate what actions were performed and the results of those actions.
The County agrees with the finding. See Corrective Action Plan in the following section.
This is a repeat finding from the immediate previous audit, 2023-001.
In accordance with 42 CFR 435, documentation must be obtained as needed to
determine if a recipient meets specific standards, and documentation must be
maintained to support eligibility determinations. Electronic matches are required at
applications and redeterminations.
Condition:
Questioned Costs:
Context:
Effect:
Identification of a
repeat finding:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL #: 93.778
Finding: 2024-002 Inadequate Request For Information
SIGNIFICANT DEFICENCY
ELIGIBILITY
Criteria:
Section III. Federal Award Findings and Questioned Costs (continued)
There were 7 errors discovered during our procedures where income or household size
was incorrectly calculated or inaccurate information was entered into the case file.
There was no known affect to eligibility and there were no known questioned costs.
We examined 60 cases from of a total of 1,176,385 Medicaid claims from the Medicaid
beneficiary report provided by NC Department of Health and Human Services to redetermine
eligibility. These findings are being reported with the financial statement audit
as it relates to Medicaid administrative cost compliance audit.
For those certifications/re-certifications there was a chance that information was not
properly documented and reconciled to NC FAST and a participant could have been
approved for benefits for which they were not eligible.
Ineffective record keeping and ineffective case review process, incomplete
documentation, and incorrect application of rules for purposes of determining eligibility.
Files should be reviewed internally to ensure proper documentation is in place for
eligibility. Workers should be retrained on what files should contain and the importance
of complete and accurate record keeping. We recommend that all files include online
verifications, documented resources of income and those amounts agree to information
in NC FAST. The results found or documentation made in case notes should clearly
indicate what actions were performed and the results of those actions.
The County agrees with the finding. See Corrective Action Plan in the following section.
This is a repeat finding from the immediate previous audit, 2023-001.
In accordance with 42 CFR 435, documentation must be obtained as needed to
determine if a recipient meets specific standards, and documentation must be
maintained to support eligibility determinations. Electronic matches are required at
applications and redeterminations.
Condition:
Questioned Costs:
Context:
Effect:
Identification of a
repeat finding:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
Section III. Federal Award Findings and Questioned Costs (continued)
The County agrees with the finding. See Corrective Action Plan in the following section.
Files should be reviewed internally to ensure proper documentation is in place for
eligibility. Workers should be retrained on what files should contain and the importance
of complete and accurate record keeping. We recommend that all files include online
verifications, documented resources and income and those amounts agree to information
in NC FAST. The results found or documentation made in case notes should clearly
indicate what actions were performed and the results of those actions.
Ineffective record keeping and ineffective case review process, incomplete
documentation, and incorrect application of rules for purposes of determining eligibility.
This is a repeat finding from the immediate previous audit, 2023-003.
For those certifications/re-certifications there was a chance that information was not
properly documented and reconciled to NC FAST and applicants could have been
approved for benefits for which they were not eligible.
We examined 60 cases from of a total of 1,176,385 Medicaid claims from the Medicaid
beneficiary report provided by NC Department of Health and Human Services to redetermine
eligibility. These findings are being reported with the financial statement audit
as it relates to Medicaid administrative cost compliance audit.
There was no known affect to eligibility and there were no known questioned costs.
There were 2 errors discovered during our procedures where required information
needed for eligibility determinations were not requested or not requested timely at
applications or redeterminations.
U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL #: 93.778
Finding: 2024-003 Non-cooperation with Child Support Procedures
SIGNIFICANT DEFICENCY
ELIGIBILITY
Criteria:
Condition:
Questioned Costs:
Context:
Effect:
Identification of a
repeat finding:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
This is a repeat finding from the immediate previous audit, 2023-004.
In accordance with the Medicaid Manual MA-3365, all Medicaid cases should be
evaluated and referred to the Child Support Enforcement Agency (IV-D). The Child
Support Enforcement Agency (IV-D) can assist the family in obtaining financial and/or
medical support or medical support payments from the child’s non-custodial parent.
Cooperation requirement with Social Services and Child Support Agencies must be met
or good cause for not cooperating must be established when determining Medicaid
eligibility.
There were 1 errors discovered during our procedures that referrals between DSS and
Child Support Agencies were not properly made.
There was no known affect to eligibility and there were no known questioned costs.
We examined 60 cases from of a total of 1,176,385 Medicaid claims from the Medicaid
beneficiary report provided by NC Department of Health and Human Services to redetermine
eligibility. These findings are being reported with the financial statement audit
as it relates to Medicaid administrative cost compliance audit.
For those certifications/re-certifications there was a chance that information was not
properly documented and reconciled to NC FAST and applicants could have been
approved for benefits for which they were not eligible.
Section III. Federal Award Findings and Questioned Costs (continued)
Error in reading the ACTS report and/or ineffective case review process.
The County agrees with the finding. See Corrective Action Plan in the following section.
Files should be reviewed internally to ensure proper information is in place and
necessary procedures are taken when determining eligibility. The results found or
documentation made in case notes should clearly indicate what actions were performed
and the results of those actions.
U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL #: 93.778
Finding: 2024-004 Untimely Review of SSI Terminations
SIGNIFICANT DEFICENCY
ELIGIBILITY
Criteria:
Condition:
Questioned Costs:
Context:
Effect:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
Section III. Federal Award Findings and Questioned Costs (continued)
Ineffective communication between departments within the Department of Social
Services. One area within DSS received State communications that applicants would no
longer be eligible for SSI benefits and the County needed to conduct an ex-parte review.
This information was not shared with other departments in DSS from which the
recipient was also receiving benefits.
Any State communications related to applicants/beneficiaries should be shared with all
areas from which the participant receives benefits. State files should be reviewed
internally to ensure all actions have been properly closed and the corrective action has
been taken. Workers should be retrained on what process needs to be followed when
State communications are received.
The County agrees with the finding. See Corrective Action Plan in the following section.
In accordance with the Medicaid Manual MA-3120, the State sends notification to the
County when a participant is no longer eligible under a SSI determination. The County
has a certain time period to initiate an ex-parte review to determine whether the recipient
qualifies for Medicaid under any other coverage group, such as Family and Children's
Medicaid, North Carolina Health Choice for Children, Work First Family Assistance, or
Medicaid for the Aged, Blind and Disabled.
There was 1 applicant/beneficiary not reviewed timely and determined to be eligible for
Medicaid when their SSI benefits were terminated.
There was no known affect to eligibility and there were no known questioned costs.
We examined 60 cases from of a total of 1,176,385 Medicaid claims from the Medicaid
beneficiary report provided by NC Department of Health and Human Services to redetermine
eligibility. These findings are being reported with the financial statement audit
as it relates to Medicaid administrative cost compliance audit.
The County did not initiate ex-parte review timely, therefore, no eligibility review was
completed in the required time period. The lack of follow up and certification lead to
applicants receiving Medicaid benefits for which they were not eligible.
U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Food and Nutrition Services (FNS) Cluster
AL #: 10.551 and 10.561
Finding: 2024-005 Internal Controls Related to FNS Eligibility Determinations
SIGNIFICANT DEFICENCY
ELIGIBILITY
Criteria:
Condition:
Questioned Costs:
Context:
Effect:
Section III. Federal Award Findings and Questioned Costs (continued)
Per Section 200.303 of the Uniform Grant Guidance, a non-federal entity must establish
and maintain effective internal control over the Federal award that provides reasonable
assurance that the non-federal entity is managing the Federal award in compliance with
Federal statutes, regulations, and the terms and conditions of the Federal award. The State
has provided policies and procedures to ensure that the County is meeting the federal
guidance, relevant policies are:
Food and Nutrition Services Policy 305 describes the verification sources and
requirements and the FNS units primary responsibility for providing documentary
evidence to support statements on applications and recertifications and procedures
required if the statements by applicant/beneficiary are questionable.
Food and Nutrition Services Policy 300 describes the sources of income countable and
not countable to the household for determining financial eligibility.
Food and Nutrition Services Policy 310 describes the procedures related to verifying
changes in income (i.e. termination, end of contract, temporary, etc.).
There were a total of 5 errors found in our testing: 1 instance where child support income
was incorrectly calculated and entered in NCFAST, 1 instance where earned income was
incorrectly caclculated and entered in NCFAST, 1 instance where an OVS report was not
included in the case file, 1 instance where a work work registration was not completed,
and 1 instance where a mortgage payment was entered into NCFAST but evidence shows
that the absent parent was paying mortgage in lieu of child support.
There was no known affect to eligibility and there were no known questioned costs.
We examined 25 of 96,362 FNS cases from a report of all active FNS beneficiaries
provided by Brunswick County's Department of Human Services. The finding is being
reported with the financial statement audit as it relates to FNS administrative cost
compliance audit.
For those certifications/re-certifications there was a chance that information was not
properly documented and reconciled to NC FAST and a participant could have been
approved for benefits for which they were not eligible.
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
AL #: 93.778
SIGNIFICANT DEFICENCY: Findings 2024-001, 2024-002, 2024-003, and 2024-004 also apply to State
requirements and State Awards.
Section IV. State Award Findings and Questioned Costs
Program Name: Medical Assistance Program (Medicaid; Title XIX)
Section III. Federal Award Findings and Questioned Costs (continued)
Due to the errors noted, eligibility cannot be sufficiently substantiated and there is a risk
that the County could provide funding and/or benefits to individuals who are not
program eligible.
The County should provide training of management and staff on the program's eligibility
requirements, proper case review process, and required verifications for eligibility. Also,
the County should ensure that their formal internal review process is adequately
completed to identify and correct errors in case reviews.
The County agrees with the finding. See Corrective Action Plan in the following section.
U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL #: 93.778
Finding: 2024-001 Inaccurate Information Entry
SIGNIFICANT DEFICENCY
ELIGIBILITY
Criteria:
Section III. Federal Award Findings and Questioned Costs
Section I. Summary of Auditors' Results (continued)
Section II. Financial Statement Findings
Type of auditors' report issued on compliance for major State programs:
In accordance with 42 CFR 435, documentation must be obtained as needed to
determine if a recipient meets specific standards, and documentation must be
maintained to support eligibility determinations. In accordance with 2 CFR 200,
management should have an adequate system of internal controls procedures in place to
ensure an applicant is properly determined or redetermined for benefits.
Condition:
Questioned Costs:
Context:
Effect:
Identification of a
repeat finding:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL #: 93.778
Finding: 2024-002 Inadequate Request For Information
SIGNIFICANT DEFICENCY
ELIGIBILITY
Criteria:
Section III. Federal Award Findings and Questioned Costs (continued)
There were 7 errors discovered during our procedures where income or household size
was incorrectly calculated or inaccurate information was entered into the case file.
There was no known affect to eligibility and there were no known questioned costs.
We examined 60 cases from of a total of 1,176,385 Medicaid claims from the Medicaid
beneficiary report provided by NC Department of Health and Human Services to redetermine
eligibility. These findings are being reported with the financial statement audit
as it relates to Medicaid administrative cost compliance audit.
For those certifications/re-certifications there was a chance that information was not
properly documented and reconciled to NC FAST and a participant could have been
approved for benefits for which they were not eligible.
Ineffective record keeping and ineffective case review process, incomplete
documentation, and incorrect application of rules for purposes of determining eligibility.
Files should be reviewed internally to ensure proper documentation is in place for
eligibility. Workers should be retrained on what files should contain and the importance
of complete and accurate record keeping. We recommend that all files include online
verifications, documented resources of income and those amounts agree to information
in NC FAST. The results found or documentation made in case notes should clearly
indicate what actions were performed and the results of those actions.
The County agrees with the finding. See Corrective Action Plan in the following section.
This is a repeat finding from the immediate previous audit, 2023-001.
In accordance with 42 CFR 435, documentation must be obtained as needed to
determine if a recipient meets specific standards, and documentation must be
maintained to support eligibility determinations. Electronic matches are required at
applications and redeterminations.
Condition:
Questioned Costs:
Context:
Effect:
Identification of a
repeat finding:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL #: 93.778
Finding: 2024-002 Inadequate Request For Information
SIGNIFICANT DEFICENCY
ELIGIBILITY
Criteria:
Section III. Federal Award Findings and Questioned Costs (continued)
There were 7 errors discovered during our procedures where income or household size
was incorrectly calculated or inaccurate information was entered into the case file.
There was no known affect to eligibility and there were no known questioned costs.
We examined 60 cases from of a total of 1,176,385 Medicaid claims from the Medicaid
beneficiary report provided by NC Department of Health and Human Services to redetermine
eligibility. These findings are being reported with the financial statement audit
as it relates to Medicaid administrative cost compliance audit.
For those certifications/re-certifications there was a chance that information was not
properly documented and reconciled to NC FAST and a participant could have been
approved for benefits for which they were not eligible.
Ineffective record keeping and ineffective case review process, incomplete
documentation, and incorrect application of rules for purposes of determining eligibility.
Files should be reviewed internally to ensure proper documentation is in place for
eligibility. Workers should be retrained on what files should contain and the importance
of complete and accurate record keeping. We recommend that all files include online
verifications, documented resources of income and those amounts agree to information
in NC FAST. The results found or documentation made in case notes should clearly
indicate what actions were performed and the results of those actions.
The County agrees with the finding. See Corrective Action Plan in the following section.
This is a repeat finding from the immediate previous audit, 2023-001.
In accordance with 42 CFR 435, documentation must be obtained as needed to
determine if a recipient meets specific standards, and documentation must be
maintained to support eligibility determinations. Electronic matches are required at
applications and redeterminations.
Condition:
Questioned Costs:
Context:
Effect:
Identification of a
repeat finding:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
Section III. Federal Award Findings and Questioned Costs (continued)
The County agrees with the finding. See Corrective Action Plan in the following section.
Files should be reviewed internally to ensure proper documentation is in place for
eligibility. Workers should be retrained on what files should contain and the importance
of complete and accurate record keeping. We recommend that all files include online
verifications, documented resources and income and those amounts agree to information
in NC FAST. The results found or documentation made in case notes should clearly
indicate what actions were performed and the results of those actions.
Ineffective record keeping and ineffective case review process, incomplete
documentation, and incorrect application of rules for purposes of determining eligibility.
This is a repeat finding from the immediate previous audit, 2023-003.
For those certifications/re-certifications there was a chance that information was not
properly documented and reconciled to NC FAST and applicants could have been
approved for benefits for which they were not eligible.
We examined 60 cases from of a total of 1,176,385 Medicaid claims from the Medicaid
beneficiary report provided by NC Department of Health and Human Services to redetermine
eligibility. These findings are being reported with the financial statement audit
as it relates to Medicaid administrative cost compliance audit.
There was no known affect to eligibility and there were no known questioned costs.
There were 2 errors discovered during our procedures where required information
needed for eligibility determinations were not requested or not requested timely at
applications or redeterminations.
U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL #: 93.778
Finding: 2024-003 Non-cooperation with Child Support Procedures
SIGNIFICANT DEFICENCY
ELIGIBILITY
Criteria:
Condition:
Questioned Costs:
Context:
Effect:
Identification of a
repeat finding:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
This is a repeat finding from the immediate previous audit, 2023-004.
In accordance with the Medicaid Manual MA-3365, all Medicaid cases should be
evaluated and referred to the Child Support Enforcement Agency (IV-D). The Child
Support Enforcement Agency (IV-D) can assist the family in obtaining financial and/or
medical support or medical support payments from the child’s non-custodial parent.
Cooperation requirement with Social Services and Child Support Agencies must be met
or good cause for not cooperating must be established when determining Medicaid
eligibility.
There were 1 errors discovered during our procedures that referrals between DSS and
Child Support Agencies were not properly made.
There was no known affect to eligibility and there were no known questioned costs.
We examined 60 cases from of a total of 1,176,385 Medicaid claims from the Medicaid
beneficiary report provided by NC Department of Health and Human Services to redetermine
eligibility. These findings are being reported with the financial statement audit
as it relates to Medicaid administrative cost compliance audit.
For those certifications/re-certifications there was a chance that information was not
properly documented and reconciled to NC FAST and applicants could have been
approved for benefits for which they were not eligible.
Section III. Federal Award Findings and Questioned Costs (continued)
Error in reading the ACTS report and/or ineffective case review process.
The County agrees with the finding. See Corrective Action Plan in the following section.
Files should be reviewed internally to ensure proper information is in place and
necessary procedures are taken when determining eligibility. The results found or
documentation made in case notes should clearly indicate what actions were performed
and the results of those actions.
U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL #: 93.778
Finding: 2024-004 Untimely Review of SSI Terminations
SIGNIFICANT DEFICENCY
ELIGIBILITY
Criteria:
Condition:
Questioned Costs:
Context:
Effect:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
Section III. Federal Award Findings and Questioned Costs (continued)
Ineffective communication between departments within the Department of Social
Services. One area within DSS received State communications that applicants would no
longer be eligible for SSI benefits and the County needed to conduct an ex-parte review.
This information was not shared with other departments in DSS from which the
recipient was also receiving benefits.
Any State communications related to applicants/beneficiaries should be shared with all
areas from which the participant receives benefits. State files should be reviewed
internally to ensure all actions have been properly closed and the corrective action has
been taken. Workers should be retrained on what process needs to be followed when
State communications are received.
The County agrees with the finding. See Corrective Action Plan in the following section.
In accordance with the Medicaid Manual MA-3120, the State sends notification to the
County when a participant is no longer eligible under a SSI determination. The County
has a certain time period to initiate an ex-parte review to determine whether the recipient
qualifies for Medicaid under any other coverage group, such as Family and Children's
Medicaid, North Carolina Health Choice for Children, Work First Family Assistance, or
Medicaid for the Aged, Blind and Disabled.
There was 1 applicant/beneficiary not reviewed timely and determined to be eligible for
Medicaid when their SSI benefits were terminated.
There was no known affect to eligibility and there were no known questioned costs.
We examined 60 cases from of a total of 1,176,385 Medicaid claims from the Medicaid
beneficiary report provided by NC Department of Health and Human Services to redetermine
eligibility. These findings are being reported with the financial statement audit
as it relates to Medicaid administrative cost compliance audit.
The County did not initiate ex-parte review timely, therefore, no eligibility review was
completed in the required time period. The lack of follow up and certification lead to
applicants receiving Medicaid benefits for which they were not eligible.
U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Food and Nutrition Services (FNS) Cluster
AL #: 10.551 and 10.561
Finding: 2024-005 Internal Controls Related to FNS Eligibility Determinations
SIGNIFICANT DEFICENCY
ELIGIBILITY
Criteria:
Condition:
Questioned Costs:
Context:
Effect:
Section III. Federal Award Findings and Questioned Costs (continued)
Per Section 200.303 of the Uniform Grant Guidance, a non-federal entity must establish
and maintain effective internal control over the Federal award that provides reasonable
assurance that the non-federal entity is managing the Federal award in compliance with
Federal statutes, regulations, and the terms and conditions of the Federal award. The State
has provided policies and procedures to ensure that the County is meeting the federal
guidance, relevant policies are:
Food and Nutrition Services Policy 305 describes the verification sources and
requirements and the FNS units primary responsibility for providing documentary
evidence to support statements on applications and recertifications and procedures
required if the statements by applicant/beneficiary are questionable.
Food and Nutrition Services Policy 300 describes the sources of income countable and
not countable to the household for determining financial eligibility.
Food and Nutrition Services Policy 310 describes the procedures related to verifying
changes in income (i.e. termination, end of contract, temporary, etc.).
There were a total of 5 errors found in our testing: 1 instance where child support income
was incorrectly calculated and entered in NCFAST, 1 instance where earned income was
incorrectly caclculated and entered in NCFAST, 1 instance where an OVS report was not
included in the case file, 1 instance where a work work registration was not completed,
and 1 instance where a mortgage payment was entered into NCFAST but evidence shows
that the absent parent was paying mortgage in lieu of child support.
There was no known affect to eligibility and there were no known questioned costs.
We examined 25 of 96,362 FNS cases from a report of all active FNS beneficiaries
provided by Brunswick County's Department of Human Services. The finding is being
reported with the financial statement audit as it relates to FNS administrative cost
compliance audit.
For those certifications/re-certifications there was a chance that information was not
properly documented and reconciled to NC FAST and a participant could have been
approved for benefits for which they were not eligible.
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
AL #: 93.778
SIGNIFICANT DEFICENCY: Findings 2024-001, 2024-002, 2024-003, and 2024-004 also apply to State
requirements and State Awards.
Section IV. State Award Findings and Questioned Costs
Program Name: Medical Assistance Program (Medicaid; Title XIX)
Section III. Federal Award Findings and Questioned Costs (continued)
Due to the errors noted, eligibility cannot be sufficiently substantiated and there is a risk
that the County could provide funding and/or benefits to individuals who are not
program eligible.
The County should provide training of management and staff on the program's eligibility
requirements, proper case review process, and required verifications for eligibility. Also,
the County should ensure that their formal internal review process is adequately
completed to identify and correct errors in case reviews.
The County agrees with the finding. See Corrective Action Plan in the following section.