U.S. Department of Health and Human Services
Passed-through N.C. Department of Health and Human Services
Program Name: Medicaid Cluster
AL Number: 93.778
Grant Number: XIX-MAP
Program Name: Child Care Development Fund Cluster
AL Number: 93.596
Grant Number: G1801NCCCDF
Non-Material Non-Compliance
Material Weakness, Special Tests and Provisions
Criteria: Per the North Carolina DSS Crosscutting Requirements compliance supplement, counties must acquire adequate case documentation to substantiate the claim entry into the Enterprise Program Integrity (EPI). This information includes but is not limited to the dates of the overpayment period, documentary evidence to substantiate that an overpayment occurred, such as wage stubs or verification from an employer, other income verification and household composition verification, and the budgets used to compute the amount of the overpayment. This also includes proper use of standardized form 1682.
Condition: We noted nine instances of claims entered in EPI where adequate case documentation was not maintained. Nine case files did not include a signed form 1682.
Context: We sampled 40 claims that were current in the EPI system and noted the above condition in nine (22.5%) of the claims tested.
Effect: The County may not have required supporting documentation for claims entered into the EPI system. There is a risk that claims may not be valid as a result.
Cause: Turnover in the department left duties unfulfilled and unsigned or missing forms in the case files.
Questioned Cost: 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 implement controls, such as additional training and supervisory review, to ensure that all required documentation is adequate and maintained within the case file.
Views of Responsible Officials and Planned Corrective Action: Management concurs with the finding. See Corrective Action Plan.
U.S. Department of Health and Human Services
Passed-through N.C. Department of Health and Human Services
Program Name: Medicaid Cluster
AL Number: 93.778
Grant Number: XIX-MAP
Program Name: Child Care Development Fund Cluster
AL Number: 93.596
Grant Number: G1801NCCCDF
Non-Material Non-Compliance
Material Weakness, Special Tests and Provisions
Criteria: Per the North Carolina DSS Crosscutting Requirements compliance supplement, counties must acquire adequate case documentation to substantiate the claim entry into the Enterprise Program Integrity (EPI). This information includes but is not limited to the dates of the overpayment period, documentary evidence to substantiate that an overpayment occurred, such as wage stubs or verification from an employer, other income verification and household composition verification, and the budgets used to compute the amount of the overpayment. This also includes proper use of standardized form 1682.
Condition: We noted nine instances of claims entered in EPI where adequate case documentation was not maintained. Nine case files did not include a signed form 1682.
Context: We sampled 40 claims that were current in the EPI system and noted the above condition in nine (22.5%) of the claims tested.
Effect: The County may not have required supporting documentation for claims entered into the EPI system. There is a risk that claims may not be valid as a result.
Cause: Turnover in the department left duties unfulfilled and unsigned or missing forms in the case files.
Questioned Cost: 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 implement controls, such as additional training and supervisory review, to ensure that all required documentation is adequate and maintained within the case file.
Views of Responsible Officials and Planned Corrective Action: Management concurs with the finding. See Corrective Action Plan.
U.S. Department of Health and Human Services
Passed-through N.C. Department of Health and Human Services
Program Name: Medicaid Cluster
AL Number: 93.778
Grant Number: XIX-MAP
Program Name: Child Care Development Fund Cluster
AL Number: 93.596
Grant Number: G1801NCCCDF
Non-Material Non-Compliance
Significant Deficiency, Special Tests and Provisions
Criteria: In accordance with the Office of Management and Budget Memorandum M-07-16, safeguarding personally identifiable information in the possession of the government and preventing its breach are essential to ensure the government retains the trust of the American public. All individuals with authorized access to personally identifiable information and their supervisors must sign, at least annually, a document clearly describing their responsibilities.
Condition: We noted three instances where an employee’s file did not include a signed confidentiality document.
Context: Of the 25 personnel files examined, three (12%) did not contain the signed document.
Effect: Sufficient back up documentation did not exist to support the employee received the proper PII training.
Cause: Lack of proper internal controls over PII training and documentation.
Questioned Cost: This finding represents an internal control issue; therefore, questioned costs are not applicable.
Recommendation: The County should implement a review process to ensure all employees receive the required PII training each year.
Views of Responsible Officials and Planned Corrective Action: Management concurs with the finding. See Corrective Action Plan.
U.S. Department of Health and Human Services
Passed-through N.C. Department of Health and Human Services
Program Name: Medicaid Cluster
AL Number: 93.778
Grant Number: XIX-MAP
Program Name: Child Care Development Fund Cluster
AL Number: 93.596
Grant Number: G1801NCCCDF
Non-Material Non-Compliance
Significant Deficiency, Special Tests and Provisions
Criteria: In accordance with the Office of Management and Budget Memorandum M-07-16, safeguarding personally identifiable information in the possession of the government and preventing its breach are essential to ensure the government retains the trust of the American public. All individuals with authorized access to personally identifiable information and their supervisors must sign, at least annually, a document clearly describing their responsibilities.
Condition: We noted three instances where an employee’s file did not include a signed confidentiality document.
Context: Of the 25 personnel files examined, three (12%) did not contain the signed document.
Effect: Sufficient back up documentation did not exist to support the employee received the proper PII training.
Cause: Lack of proper internal controls over PII training and documentation.
Questioned Cost: This finding represents an internal control issue; therefore, questioned costs are not applicable.
Recommendation: The County should implement a review process to ensure all employees receive the required PII training each year.
Views of Responsible Officials and Planned Corrective Action: Management concurs with the finding. See Corrective Action Plan.
U.S. Department of Health and Human Services
Passed-through N.C. Department of Health and Human Services
Program Name: Medicaid Cluster
AL Number: 93.778
Grant Number: XIX-MAP
Program Name: Child Care Development Fund Cluster
AL Number: 93.596
Grant Number: G1801NCCCDF
Non-Material Non-Compliance
Material Weakness, Special Tests and Provisions
Criteria: Per the North Carolina DSS Crosscutting Requirements compliance supplement, counties must acquire adequate case documentation to substantiate the claim entry into the Enterprise Program Integrity (EPI). This information includes but is not limited to the dates of the overpayment period, documentary evidence to substantiate that an overpayment occurred, such as wage stubs or verification from an employer, other income verification and household composition verification, and the budgets used to compute the amount of the overpayment. This also includes proper use of standardized form 1682.
Condition: We noted nine instances of claims entered in EPI where adequate case documentation was not maintained. Nine case files did not include a signed form 1682.
Context: We sampled 40 claims that were current in the EPI system and noted the above condition in nine (22.5%) of the claims tested.
Effect: The County may not have required supporting documentation for claims entered into the EPI system. There is a risk that claims may not be valid as a result.
Cause: Turnover in the department left duties unfulfilled and unsigned or missing forms in the case files.
Questioned Cost: 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 implement controls, such as additional training and supervisory review, to ensure that all required documentation is adequate and maintained within the case file.
Views of Responsible Officials and Planned Corrective Action: Management concurs with the finding. See Corrective Action Plan.
U.S. Department of Health and Human Services
Passed-through N.C. Department of Health and Human Services
Program Name: Medicaid Cluster
AL Number: 93.778
Grant Number: XIX-MAP
Program Name: Child Care Development Fund Cluster
AL Number: 93.596
Grant Number: G1801NCCCDF
Non-Material Non-Compliance
Material Weakness, Special Tests and Provisions
Criteria: Per the North Carolina DSS Crosscutting Requirements compliance supplement, counties must acquire adequate case documentation to substantiate the claim entry into the Enterprise Program Integrity (EPI). This information includes but is not limited to the dates of the overpayment period, documentary evidence to substantiate that an overpayment occurred, such as wage stubs or verification from an employer, other income verification and household composition verification, and the budgets used to compute the amount of the overpayment. This also includes proper use of standardized form 1682.
Condition: We noted nine instances of claims entered in EPI where adequate case documentation was not maintained. Nine case files did not include a signed form 1682.
Context: We sampled 40 claims that were current in the EPI system and noted the above condition in nine (22.5%) of the claims tested.
Effect: The County may not have required supporting documentation for claims entered into the EPI system. There is a risk that claims may not be valid as a result.
Cause: Turnover in the department left duties unfulfilled and unsigned or missing forms in the case files.
Questioned Cost: 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 implement controls, such as additional training and supervisory review, to ensure that all required documentation is adequate and maintained within the case file.
Views of Responsible Officials and Planned Corrective Action: Management concurs with the finding. See Corrective Action Plan.
U.S. Department of Health and Human Services
Passed-through N.C. Department of Health and Human Services
Program Name: Medicaid Cluster
AL Number: 93.778
Grant Number: XIX-MAP
Program Name: Child Care Development Fund Cluster
AL Number: 93.596
Grant Number: G1801NCCCDF
Non-Material Non-Compliance
Significant Deficiency, Special Tests and Provisions
Criteria: In accordance with the Office of Management and Budget Memorandum M-07-16, safeguarding personally identifiable information in the possession of the government and preventing its breach are essential to ensure the government retains the trust of the American public. All individuals with authorized access to personally identifiable information and their supervisors must sign, at least annually, a document clearly describing their responsibilities.
Condition: We noted three instances where an employee’s file did not include a signed confidentiality document.
Context: Of the 25 personnel files examined, three (12%) did not contain the signed document.
Effect: Sufficient back up documentation did not exist to support the employee received the proper PII training.
Cause: Lack of proper internal controls over PII training and documentation.
Questioned Cost: This finding represents an internal control issue; therefore, questioned costs are not applicable.
Recommendation: The County should implement a review process to ensure all employees receive the required PII training each year.
Views of Responsible Officials and Planned Corrective Action: Management concurs with the finding. See Corrective Action Plan.
U.S. Department of Health and Human Services
Passed-through N.C. Department of Health and Human Services
Program Name: Medicaid Cluster
AL Number: 93.778
Grant Number: XIX-MAP
Program Name: Child Care Development Fund Cluster
AL Number: 93.596
Grant Number: G1801NCCCDF
Non-Material Non-Compliance
Significant Deficiency, Special Tests and Provisions
Criteria: In accordance with the Office of Management and Budget Memorandum M-07-16, safeguarding personally identifiable information in the possession of the government and preventing its breach are essential to ensure the government retains the trust of the American public. All individuals with authorized access to personally identifiable information and their supervisors must sign, at least annually, a document clearly describing their responsibilities.
Condition: We noted three instances where an employee’s file did not include a signed confidentiality document.
Context: Of the 25 personnel files examined, three (12%) did not contain the signed document.
Effect: Sufficient back up documentation did not exist to support the employee received the proper PII training.
Cause: Lack of proper internal controls over PII training and documentation.
Questioned Cost: This finding represents an internal control issue; therefore, questioned costs are not applicable.
Recommendation: The County should implement a review process to ensure all employees receive the required PII training each year.
Views of Responsible Officials and Planned Corrective Action: Management concurs with the finding. See Corrective Action Plan.