Condition: Reports required to be submitted under the Federal Funding Accountability and Transparency
Act (FFATA) were not submitted during the year ended June 30, 2024. Management has not made
progress on the prior year finding.
Criteria: Under the requirements of FFATA (Pub. L. No. 109-282), as amended by Section 6202 of Public
Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and
Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Reports are due
by the end of the month following the month in which the prime awardee awards any sub-award equal to
or greater than $30,000.
Context: FFATA reports were not submitted.
Cause: The Department has not implemented the proper controls to ensure all required FFATA reports
were submitted to the federal agency.
Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did
not receive timely reporting and did not receive all the information as requested from the Department.
Questioned Costs: None
Repeat Finding: This is a repeat and modified finding (prior year finding 2023-002; original finding
2021-001).
Recommendation: We recommend that the Department ensure that adequate controls are in place to
ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all
required data is included. We further recommend that the reporting data be reviewed internally by
someone other than the person preparing the reports.
Current Status/Plan of Action: ASD staff from the Contracts and Procurement and Grant Management
Bureau will work together to monitor any new activity that will need to be reported on the Federal Funding
Accountability and Transparency Act (FFATA). ASD established and implemented a new
contract/agreement system called Bonfire in January 2024. This system is an automated system that
includes all the information that was entered on the Contract Request Form (CRF) that was previously
used in the Contracts and Procurement Bureau and a copy of the proposed contract/agreement. Now,
there is a specific field that can be used to track if any new contact/agreement must be reported on the
FFATA. These contracts/agreements are reviewed and pre-approved in Bonfire by many HSD staff which
include the Contract and Procurement Bureau Chief and the ASD Director/CFO. We can monitor the
FFATA field as we review and provide information to the Grants Management Bureau Chief in real time.
We can also run monthly reports to review and track this field to ensure that any new
contracts/agreements were not missed to ensure timely FFATA reporting. ASD will ensure that a FFATA
sub-award report is submitted by the of the month following the month in which HSD awards any subgrants
greater than or equal to $30,000.
Responsible Person: Grants Bureau Chief; Contracts and Procurement Bureau Chief
Condition: Reports required to be submitted under the Federal Funding Accountability and Transparency
Act (FFATA) were not submitted during the year ended June 30, 2024. Management has not made
progress on the prior year finding.
Criteria: Under the requirements of FFATA (Pub. L. No. 109-282), as amended by Section 6202 of Public
Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and
Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Reports are due
by the end of the month following the month in which the prime awardee awards any sub-award equal to
or greater than $30,000.
Context: FFATA reports were not submitted.
Cause: The Department has not implemented the proper controls to ensure all required FFATA reports
were submitted to the federal agency.
Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did
not receive timely reporting and did not receive all the information as requested from the Department.
Questioned Costs: None
Repeat Finding: This is a repeat and modified finding (prior year finding 2023-002; original finding
2021-001).
Recommendation: We recommend that the Department ensure that adequate controls are in place to
ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all
required data is included. We further recommend that the reporting data be reviewed internally by
someone other than the person preparing the reports.
Current Status/Plan of Action: ASD staff from the Contracts and Procurement and Grant Management
Bureau will work together to monitor any new activity that will need to be reported on the Federal Funding
Accountability and Transparency Act (FFATA). ASD established and implemented a new
contract/agreement system called Bonfire in January 2024. This system is an automated system that
includes all the information that was entered on the Contract Request Form (CRF) that was previously
used in the Contracts and Procurement Bureau and a copy of the proposed contract/agreement. Now,
there is a specific field that can be used to track if any new contact/agreement must be reported on the
FFATA. These contracts/agreements are reviewed and pre-approved in Bonfire by many HSD staff which
include the Contract and Procurement Bureau Chief and the ASD Director/CFO. We can monitor the
FFATA field as we review and provide information to the Grants Management Bureau Chief in real time.
We can also run monthly reports to review and track this field to ensure that any new
contracts/agreements were not missed to ensure timely FFATA reporting. ASD will ensure that a FFATA
sub-award report is submitted by the of the month following the month in which HSD awards any subgrants
greater than or equal to $30,000.
Responsible Person: Grants Bureau Chief; Contracts and Procurement Bureau Chief
Condition: Required screening and valid license verification for 9 of 40 providers tested was not properly
supported by the Department's records. Management has made progress on the prior year finding. A
program was implemented to address the transfer of screening records from the legacy system into the
current MMIS system and to provide monthly screenings of providers. However, due to the timing of the
corrective actions, there are certain providers remaining in the system without the required screening
documentation.
Criteria: 42 CFR 455.410 states that the Department must require all enrolled providers to be screened.
Per 42 CFR 455.412, the Department must verify the provider’s license has not expired and is valid.
Context: A sample of 40 out of approximately 23,500 providers who received payment during the year
were tested to determine whether a required screening was performed before the provider was enrolled.
For 9 of 40 providers tested, the Department was not able to provide documentation that the required
screening was performed. Management has made progress on the prior year finding. A program was
implemented to address the transfer of screening records from the legacy system into the current MMIS
system and to provide monthly screenings of providers. However, due to the timing of the corrective
actions, there are certain providers remaining in the system without the required screening
documentation.
Cause: In certain instances, information from the legacy system was not transferred to the current MMIS.
Additionally, certain providers who received single-case approvals were being excluded from the
revalidation processes in place.
Effect: There is no documentation to show that a provider screening and license verification were
conducted to show compliance with Medicaid requirements.
Questioned Cost: None.
Repeat Finding: This is a repeat finding (prior year finding 2023-001; original finding 2022-003).
Recommendation: We recommend that the Department review and update controls to ensure proper
screening and license verification is performed for all providers and that documentation of the screening
and verification is retained in all cases.
Current Status/Plan of Action: The Corrective Action Plan (CAP) is currently in motion with the
transition from our previous Legacy enrollment system to the new Benefit Management Services (BMS)
System. BMS system will track license and certification expiration dates and will auto terminate accounts
with expired date. The BMS system went live on November 8, 2024, and all accounts with an expired
license and certification date have been auto terminated. The State and the new vendor will complete an
audit on all accounts with a missing license and certification information to ensure correct action is taken
for or against the account. The action will be completed by February 1, 2025.
Responsible Person: Staff Manager, Policy and Provider Services Bureau, Medical Assistance Division
Condition: Required screening and valid license verification for 9 of 40 providers tested was not properly
supported by the Department's records. Management has made progress on the prior year finding. A
program was implemented to address the transfer of screening records from the legacy system into the
current MMIS system and to provide monthly screenings of providers. However, due to the timing of the
corrective actions, there are certain providers remaining in the system without the required screening
documentation.
Criteria: 42 CFR 455.410 states that the Department must require all enrolled providers to be screened.
Per 42 CFR 455.412, the Department must verify the provider’s license has not expired and is valid.
Context: A sample of 40 out of approximately 23,500 providers who received payment during the year
were tested to determine whether a required screening was performed before the provider was enrolled.
For 9 of 40 providers tested, the Department was not able to provide documentation that the required
screening was performed. Management has made progress on the prior year finding. A program was
implemented to address the transfer of screening records from the legacy system into the current MMIS
system and to provide monthly screenings of providers. However, due to the timing of the corrective
actions, there are certain providers remaining in the system without the required screening
documentation.
Cause: In certain instances, information from the legacy system was not transferred to the current MMIS.
Additionally, certain providers who received single-case approvals were being excluded from the
revalidation processes in place.
Effect: There is no documentation to show that a provider screening and license verification were
conducted to show compliance with Medicaid requirements.
Questioned Cost: None.
Repeat Finding: This is a repeat finding (prior year finding 2023-001; original finding 2022-003).
Recommendation: We recommend that the Department review and update controls to ensure proper
screening and license verification is performed for all providers and that documentation of the screening
and verification is retained in all cases.
Current Status/Plan of Action: The Corrective Action Plan (CAP) is currently in motion with the
transition from our previous Legacy enrollment system to the new Benefit Management Services (BMS)
System. BMS system will track license and certification expiration dates and will auto terminate accounts
with expired date. The BMS system went live on November 8, 2024, and all accounts with an expired
license and certification date have been auto terminated. The State and the new vendor will complete an
audit on all accounts with a missing license and certification information to ensure correct action is taken
for or against the account. The action will be completed by February 1, 2025.
Responsible Person: Staff Manager, Policy and Provider Services Bureau, Medical Assistance Division
Condition: Required screening and valid license verification for 9 of 40 providers tested was not properly
supported by the Department's records. Management has made progress on the prior year finding. A
program was implemented to address the transfer of screening records from the legacy system into the
current MMIS system and to provide monthly screenings of providers. However, due to the timing of the
corrective actions, there are certain providers remaining in the system without the required screening
documentation.
Criteria: 42 CFR 455.410 states that the Department must require all enrolled providers to be screened.
Per 42 CFR 455.412, the Department must verify the provider’s license has not expired and is valid.
Context: A sample of 40 out of approximately 23,500 providers who received payment during the year
were tested to determine whether a required screening was performed before the provider was enrolled.
For 9 of 40 providers tested, the Department was not able to provide documentation that the required
screening was performed. Management has made progress on the prior year finding. A program was
implemented to address the transfer of screening records from the legacy system into the current MMIS
system and to provide monthly screenings of providers. However, due to the timing of the corrective
actions, there are certain providers remaining in the system without the required screening
documentation.
Cause: In certain instances, information from the legacy system was not transferred to the current MMIS.
Additionally, certain providers who received single-case approvals were being excluded from the
revalidation processes in place.
Effect: There is no documentation to show that a provider screening and license verification were
conducted to show compliance with Medicaid requirements.
Questioned Cost: None.
Repeat Finding: This is a repeat finding (prior year finding 2023-001; original finding 2022-003).
Recommendation: We recommend that the Department review and update controls to ensure proper
screening and license verification is performed for all providers and that documentation of the screening
and verification is retained in all cases.
Current Status/Plan of Action: The Corrective Action Plan (CAP) is currently in motion with the
transition from our previous Legacy enrollment system to the new Benefit Management Services (BMS)
System. BMS system will track license and certification expiration dates and will auto terminate accounts
with expired date. The BMS system went live on November 8, 2024, and all accounts with an expired
license and certification date have been auto terminated. The State and the new vendor will complete an
audit on all accounts with a missing license and certification information to ensure correct action is taken
for or against the account. The action will be completed by February 1, 2025.
Responsible Person: Staff Manager, Policy and Provider Services Bureau, Medical Assistance Division
Condition: Required screening and valid license verification for 9 of 40 providers tested was not properly
supported by the Department's records. Management has made progress on the prior year finding. A
program was implemented to address the transfer of screening records from the legacy system into the
current MMIS system and to provide monthly screenings of providers. However, due to the timing of the
corrective actions, there are certain providers remaining in the system without the required screening
documentation.
Criteria: 42 CFR 455.410 states that the Department must require all enrolled providers to be screened.
Per 42 CFR 455.412, the Department must verify the provider’s license has not expired and is valid.
Context: A sample of 40 out of approximately 23,500 providers who received payment during the year
were tested to determine whether a required screening was performed before the provider was enrolled.
For 9 of 40 providers tested, the Department was not able to provide documentation that the required
screening was performed. Management has made progress on the prior year finding. A program was
implemented to address the transfer of screening records from the legacy system into the current MMIS
system and to provide monthly screenings of providers. However, due to the timing of the corrective
actions, there are certain providers remaining in the system without the required screening
documentation.
Cause: In certain instances, information from the legacy system was not transferred to the current MMIS.
Additionally, certain providers who received single-case approvals were being excluded from the
revalidation processes in place.
Effect: There is no documentation to show that a provider screening and license verification were
conducted to show compliance with Medicaid requirements.
Questioned Cost: None.
Repeat Finding: This is a repeat finding (prior year finding 2023-001; original finding 2022-003).
Recommendation: We recommend that the Department review and update controls to ensure proper
screening and license verification is performed for all providers and that documentation of the screening
and verification is retained in all cases.
Current Status/Plan of Action: The Corrective Action Plan (CAP) is currently in motion with the
transition from our previous Legacy enrollment system to the new Benefit Management Services (BMS)
System. BMS system will track license and certification expiration dates and will auto terminate accounts
with expired date. The BMS system went live on November 8, 2024, and all accounts with an expired
license and certification date have been auto terminated. The State and the new vendor will complete an
audit on all accounts with a missing license and certification information to ensure correct action is taken
for or against the account. The action will be completed by February 1, 2025.
Responsible Person: Staff Manager, Policy and Provider Services Bureau, Medical Assistance Division
Condition: Required screening and valid license verification for 9 of 40 providers tested was not properly
supported by the Department's records. Management has made progress on the prior year finding. A
program was implemented to address the transfer of screening records from the legacy system into the
current MMIS system and to provide monthly screenings of providers. However, due to the timing of the
corrective actions, there are certain providers remaining in the system without the required screening
documentation.
Criteria: 42 CFR 455.410 states that the Department must require all enrolled providers to be screened.
Per 42 CFR 455.412, the Department must verify the provider’s license has not expired and is valid.
Context: A sample of 40 out of approximately 23,500 providers who received payment during the year
were tested to determine whether a required screening was performed before the provider was enrolled.
For 9 of 40 providers tested, the Department was not able to provide documentation that the required
screening was performed. Management has made progress on the prior year finding. A program was
implemented to address the transfer of screening records from the legacy system into the current MMIS
system and to provide monthly screenings of providers. However, due to the timing of the corrective
actions, there are certain providers remaining in the system without the required screening
documentation.
Cause: In certain instances, information from the legacy system was not transferred to the current MMIS.
Additionally, certain providers who received single-case approvals were being excluded from the
revalidation processes in place.
Effect: There is no documentation to show that a provider screening and license verification were
conducted to show compliance with Medicaid requirements.
Questioned Cost: None.
Repeat Finding: This is a repeat finding (prior year finding 2023-001; original finding 2022-003).
Recommendation: We recommend that the Department review and update controls to ensure proper
screening and license verification is performed for all providers and that documentation of the screening
and verification is retained in all cases.
Current Status/Plan of Action: The Corrective Action Plan (CAP) is currently in motion with the
transition from our previous Legacy enrollment system to the new Benefit Management Services (BMS)
System. BMS system will track license and certification expiration dates and will auto terminate accounts
with expired date. The BMS system went live on November 8, 2024, and all accounts with an expired
license and certification date have been auto terminated. The State and the new vendor will complete an
audit on all accounts with a missing license and certification information to ensure correct action is taken
for or against the account. The action will be completed by February 1, 2025.
Responsible Person: Staff Manager, Policy and Provider Services Bureau, Medical Assistance Division
Condition: Reports required to be submitted under the Federal Funding Accountability and Transparency
Act (FFATA) were not submitted during the year ended June 30, 2024. Management has not made
progress on the prior year finding.
Criteria: Under the requirements of FFATA (Pub. L. No. 109-282), as amended by Section 6202 of Public
Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and
Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Reports are due
by the end of the month following the month in which the prime awardee awards any sub-award equal to
or greater than $30,000.
Context: FFATA reports were not submitted.
Cause: The Department has not implemented the proper controls to ensure all required FFATA reports
were submitted to the federal agency.
Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did
not receive timely reporting and did not receive all the information as requested from the Department.
Questioned Costs: None
Repeat Finding: This is a repeat and modified finding (prior year finding 2023-002; original finding
2021-001).
Recommendation: We recommend that the Department ensure that adequate controls are in place to
ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all
required data is included. We further recommend that the reporting data be reviewed internally by
someone other than the person preparing the reports.
Current Status/Plan of Action: ASD staff from the Contracts and Procurement and Grant Management
Bureau will work together to monitor any new activity that will need to be reported on the Federal Funding
Accountability and Transparency Act (FFATA). ASD established and implemented a new
contract/agreement system called Bonfire in January 2024. This system is an automated system that
includes all the information that was entered on the Contract Request Form (CRF) that was previously
used in the Contracts and Procurement Bureau and a copy of the proposed contract/agreement. Now,
there is a specific field that can be used to track if any new contact/agreement must be reported on the
FFATA. These contracts/agreements are reviewed and pre-approved in Bonfire by many HSD staff which
include the Contract and Procurement Bureau Chief and the ASD Director/CFO. We can monitor the
FFATA field as we review and provide information to the Grants Management Bureau Chief in real time.
We can also run monthly reports to review and track this field to ensure that any new
contracts/agreements were not missed to ensure timely FFATA reporting. ASD will ensure that a FFATA
sub-award report is submitted by the of the month following the month in which HSD awards any subgrants
greater than or equal to $30,000.
Responsible Person: Grants Bureau Chief; Contracts and Procurement Bureau Chief
Condition: Reports required to be submitted under the Federal Funding Accountability and Transparency
Act (FFATA) were not submitted during the year ended June 30, 2024. Management has not made
progress on the prior year finding.
Criteria: Under the requirements of FFATA (Pub. L. No. 109-282), as amended by Section 6202 of Public
Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and
Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Reports are due
by the end of the month following the month in which the prime awardee awards any sub-award equal to
or greater than $30,000.
Context: FFATA reports were not submitted.
Cause: The Department has not implemented the proper controls to ensure all required FFATA reports
were submitted to the federal agency.
Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did
not receive timely reporting and did not receive all the information as requested from the Department.
Questioned Costs: None
Repeat Finding: This is a repeat and modified finding (prior year finding 2023-002; original finding
2021-001).
Recommendation: We recommend that the Department ensure that adequate controls are in place to
ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all
required data is included. We further recommend that the reporting data be reviewed internally by
someone other than the person preparing the reports.
Current Status/Plan of Action: ASD staff from the Contracts and Procurement and Grant Management
Bureau will work together to monitor any new activity that will need to be reported on the Federal Funding
Accountability and Transparency Act (FFATA). ASD established and implemented a new
contract/agreement system called Bonfire in January 2024. This system is an automated system that
includes all the information that was entered on the Contract Request Form (CRF) that was previously
used in the Contracts and Procurement Bureau and a copy of the proposed contract/agreement. Now,
there is a specific field that can be used to track if any new contact/agreement must be reported on the
FFATA. These contracts/agreements are reviewed and pre-approved in Bonfire by many HSD staff which
include the Contract and Procurement Bureau Chief and the ASD Director/CFO. We can monitor the
FFATA field as we review and provide information to the Grants Management Bureau Chief in real time.
We can also run monthly reports to review and track this field to ensure that any new
contracts/agreements were not missed to ensure timely FFATA reporting. ASD will ensure that a FFATA
sub-award report is submitted by the of the month following the month in which HSD awards any subgrants
greater than or equal to $30,000.
Responsible Person: Grants Bureau Chief; Contracts and Procurement Bureau Chief
Condition: Required screening and valid license verification for 9 of 40 providers tested was not properly
supported by the Department's records. Management has made progress on the prior year finding. A
program was implemented to address the transfer of screening records from the legacy system into the
current MMIS system and to provide monthly screenings of providers. However, due to the timing of the
corrective actions, there are certain providers remaining in the system without the required screening
documentation.
Criteria: 42 CFR 455.410 states that the Department must require all enrolled providers to be screened.
Per 42 CFR 455.412, the Department must verify the provider’s license has not expired and is valid.
Context: A sample of 40 out of approximately 23,500 providers who received payment during the year
were tested to determine whether a required screening was performed before the provider was enrolled.
For 9 of 40 providers tested, the Department was not able to provide documentation that the required
screening was performed. Management has made progress on the prior year finding. A program was
implemented to address the transfer of screening records from the legacy system into the current MMIS
system and to provide monthly screenings of providers. However, due to the timing of the corrective
actions, there are certain providers remaining in the system without the required screening
documentation.
Cause: In certain instances, information from the legacy system was not transferred to the current MMIS.
Additionally, certain providers who received single-case approvals were being excluded from the
revalidation processes in place.
Effect: There is no documentation to show that a provider screening and license verification were
conducted to show compliance with Medicaid requirements.
Questioned Cost: None.
Repeat Finding: This is a repeat finding (prior year finding 2023-001; original finding 2022-003).
Recommendation: We recommend that the Department review and update controls to ensure proper
screening and license verification is performed for all providers and that documentation of the screening
and verification is retained in all cases.
Current Status/Plan of Action: The Corrective Action Plan (CAP) is currently in motion with the
transition from our previous Legacy enrollment system to the new Benefit Management Services (BMS)
System. BMS system will track license and certification expiration dates and will auto terminate accounts
with expired date. The BMS system went live on November 8, 2024, and all accounts with an expired
license and certification date have been auto terminated. The State and the new vendor will complete an
audit on all accounts with a missing license and certification information to ensure correct action is taken
for or against the account. The action will be completed by February 1, 2025.
Responsible Person: Staff Manager, Policy and Provider Services Bureau, Medical Assistance Division
Condition: Required screening and valid license verification for 9 of 40 providers tested was not properly
supported by the Department's records. Management has made progress on the prior year finding. A
program was implemented to address the transfer of screening records from the legacy system into the
current MMIS system and to provide monthly screenings of providers. However, due to the timing of the
corrective actions, there are certain providers remaining in the system without the required screening
documentation.
Criteria: 42 CFR 455.410 states that the Department must require all enrolled providers to be screened.
Per 42 CFR 455.412, the Department must verify the provider’s license has not expired and is valid.
Context: A sample of 40 out of approximately 23,500 providers who received payment during the year
were tested to determine whether a required screening was performed before the provider was enrolled.
For 9 of 40 providers tested, the Department was not able to provide documentation that the required
screening was performed. Management has made progress on the prior year finding. A program was
implemented to address the transfer of screening records from the legacy system into the current MMIS
system and to provide monthly screenings of providers. However, due to the timing of the corrective
actions, there are certain providers remaining in the system without the required screening
documentation.
Cause: In certain instances, information from the legacy system was not transferred to the current MMIS.
Additionally, certain providers who received single-case approvals were being excluded from the
revalidation processes in place.
Effect: There is no documentation to show that a provider screening and license verification were
conducted to show compliance with Medicaid requirements.
Questioned Cost: None.
Repeat Finding: This is a repeat finding (prior year finding 2023-001; original finding 2022-003).
Recommendation: We recommend that the Department review and update controls to ensure proper
screening and license verification is performed for all providers and that documentation of the screening
and verification is retained in all cases.
Current Status/Plan of Action: The Corrective Action Plan (CAP) is currently in motion with the
transition from our previous Legacy enrollment system to the new Benefit Management Services (BMS)
System. BMS system will track license and certification expiration dates and will auto terminate accounts
with expired date. The BMS system went live on November 8, 2024, and all accounts with an expired
license and certification date have been auto terminated. The State and the new vendor will complete an
audit on all accounts with a missing license and certification information to ensure correct action is taken
for or against the account. The action will be completed by February 1, 2025.
Responsible Person: Staff Manager, Policy and Provider Services Bureau, Medical Assistance Division
Condition: Required screening and valid license verification for 9 of 40 providers tested was not properly
supported by the Department's records. Management has made progress on the prior year finding. A
program was implemented to address the transfer of screening records from the legacy system into the
current MMIS system and to provide monthly screenings of providers. However, due to the timing of the
corrective actions, there are certain providers remaining in the system without the required screening
documentation.
Criteria: 42 CFR 455.410 states that the Department must require all enrolled providers to be screened.
Per 42 CFR 455.412, the Department must verify the provider’s license has not expired and is valid.
Context: A sample of 40 out of approximately 23,500 providers who received payment during the year
were tested to determine whether a required screening was performed before the provider was enrolled.
For 9 of 40 providers tested, the Department was not able to provide documentation that the required
screening was performed. Management has made progress on the prior year finding. A program was
implemented to address the transfer of screening records from the legacy system into the current MMIS
system and to provide monthly screenings of providers. However, due to the timing of the corrective
actions, there are certain providers remaining in the system without the required screening
documentation.
Cause: In certain instances, information from the legacy system was not transferred to the current MMIS.
Additionally, certain providers who received single-case approvals were being excluded from the
revalidation processes in place.
Effect: There is no documentation to show that a provider screening and license verification were
conducted to show compliance with Medicaid requirements.
Questioned Cost: None.
Repeat Finding: This is a repeat finding (prior year finding 2023-001; original finding 2022-003).
Recommendation: We recommend that the Department review and update controls to ensure proper
screening and license verification is performed for all providers and that documentation of the screening
and verification is retained in all cases.
Current Status/Plan of Action: The Corrective Action Plan (CAP) is currently in motion with the
transition from our previous Legacy enrollment system to the new Benefit Management Services (BMS)
System. BMS system will track license and certification expiration dates and will auto terminate accounts
with expired date. The BMS system went live on November 8, 2024, and all accounts with an expired
license and certification date have been auto terminated. The State and the new vendor will complete an
audit on all accounts with a missing license and certification information to ensure correct action is taken
for or against the account. The action will be completed by February 1, 2025.
Responsible Person: Staff Manager, Policy and Provider Services Bureau, Medical Assistance Division
Condition: Required screening and valid license verification for 9 of 40 providers tested was not properly
supported by the Department's records. Management has made progress on the prior year finding. A
program was implemented to address the transfer of screening records from the legacy system into the
current MMIS system and to provide monthly screenings of providers. However, due to the timing of the
corrective actions, there are certain providers remaining in the system without the required screening
documentation.
Criteria: 42 CFR 455.410 states that the Department must require all enrolled providers to be screened.
Per 42 CFR 455.412, the Department must verify the provider’s license has not expired and is valid.
Context: A sample of 40 out of approximately 23,500 providers who received payment during the year
were tested to determine whether a required screening was performed before the provider was enrolled.
For 9 of 40 providers tested, the Department was not able to provide documentation that the required
screening was performed. Management has made progress on the prior year finding. A program was
implemented to address the transfer of screening records from the legacy system into the current MMIS
system and to provide monthly screenings of providers. However, due to the timing of the corrective
actions, there are certain providers remaining in the system without the required screening
documentation.
Cause: In certain instances, information from the legacy system was not transferred to the current MMIS.
Additionally, certain providers who received single-case approvals were being excluded from the
revalidation processes in place.
Effect: There is no documentation to show that a provider screening and license verification were
conducted to show compliance with Medicaid requirements.
Questioned Cost: None.
Repeat Finding: This is a repeat finding (prior year finding 2023-001; original finding 2022-003).
Recommendation: We recommend that the Department review and update controls to ensure proper
screening and license verification is performed for all providers and that documentation of the screening
and verification is retained in all cases.
Current Status/Plan of Action: The Corrective Action Plan (CAP) is currently in motion with the
transition from our previous Legacy enrollment system to the new Benefit Management Services (BMS)
System. BMS system will track license and certification expiration dates and will auto terminate accounts
with expired date. The BMS system went live on November 8, 2024, and all accounts with an expired
license and certification date have been auto terminated. The State and the new vendor will complete an
audit on all accounts with a missing license and certification information to ensure correct action is taken
for or against the account. The action will be completed by February 1, 2025.
Responsible Person: Staff Manager, Policy and Provider Services Bureau, Medical Assistance Division
Condition: Required screening and valid license verification for 9 of 40 providers tested was not properly
supported by the Department's records. Management has made progress on the prior year finding. A
program was implemented to address the transfer of screening records from the legacy system into the
current MMIS system and to provide monthly screenings of providers. However, due to the timing of the
corrective actions, there are certain providers remaining in the system without the required screening
documentation.
Criteria: 42 CFR 455.410 states that the Department must require all enrolled providers to be screened.
Per 42 CFR 455.412, the Department must verify the provider’s license has not expired and is valid.
Context: A sample of 40 out of approximately 23,500 providers who received payment during the year
were tested to determine whether a required screening was performed before the provider was enrolled.
For 9 of 40 providers tested, the Department was not able to provide documentation that the required
screening was performed. Management has made progress on the prior year finding. A program was
implemented to address the transfer of screening records from the legacy system into the current MMIS
system and to provide monthly screenings of providers. However, due to the timing of the corrective
actions, there are certain providers remaining in the system without the required screening
documentation.
Cause: In certain instances, information from the legacy system was not transferred to the current MMIS.
Additionally, certain providers who received single-case approvals were being excluded from the
revalidation processes in place.
Effect: There is no documentation to show that a provider screening and license verification were
conducted to show compliance with Medicaid requirements.
Questioned Cost: None.
Repeat Finding: This is a repeat finding (prior year finding 2023-001; original finding 2022-003).
Recommendation: We recommend that the Department review and update controls to ensure proper
screening and license verification is performed for all providers and that documentation of the screening
and verification is retained in all cases.
Current Status/Plan of Action: The Corrective Action Plan (CAP) is currently in motion with the
transition from our previous Legacy enrollment system to the new Benefit Management Services (BMS)
System. BMS system will track license and certification expiration dates and will auto terminate accounts
with expired date. The BMS system went live on November 8, 2024, and all accounts with an expired
license and certification date have been auto terminated. The State and the new vendor will complete an
audit on all accounts with a missing license and certification information to ensure correct action is taken
for or against the account. The action will be completed by February 1, 2025.
Responsible Person: Staff Manager, Policy and Provider Services Bureau, Medical Assistance Division