CONTROLS OVER ELIGIBILITY (2024-003) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2405MN5ADM and 2405MN5MAP, 2024 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2405MN5ADM and 2405MN5MAP Award Period: Year-Ended December 31, 2024 Type of Finding: Significant Deficiency in Internal Control over Compliance Criteria or Specific Requirement: Standard internal control procedures suggest that casefile eligibility determination should have a timely review documented by someone other than the preparer. Condition: During testing of controls over eligibility, it was noted the County did not have adequate internal controls designed to ensure that casefiles were reviewed for correct eligibility determination. Questioned Costs: None. Context: During testing of controls over eligibility casefile reviews, it was noted that there were no reviews for Non-MAGI cases and MAGI cases. Cause: Lack of management oversight. Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: Yes, 2023-005 Recommendation: We recommend the County increase review over casefiles and ensure that there are performed on a periodic basis throughout the year. Views of Responsible Officials: There is no disagreement with the audit finding.
CONTROLS OVER ELIGIBILITY (2024-003) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2405MN5ADM and 2405MN5MAP, 2024 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2405MN5ADM and 2405MN5MAP Award Period: Year-Ended December 31, 2024 Type of Finding: Significant Deficiency in Internal Control over Compliance Criteria or Specific Requirement: Standard internal control procedures suggest that casefile eligibility determination should have a timely review documented by someone other than the preparer. Condition: During testing of controls over eligibility, it was noted the County did not have adequate internal controls designed to ensure that casefiles were reviewed for correct eligibility determination. Questioned Costs: None. Context: During testing of controls over eligibility casefile reviews, it was noted that there were no reviews for Non-MAGI cases and MAGI cases. Cause: Lack of management oversight. Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: Yes, 2023-005 Recommendation: We recommend the County increase review over casefiles and ensure that there are performed on a periodic basis throughout the year. Views of Responsible Officials: There is no disagreement with the audit finding.
CONTROLS OVER ELIGIBILITY (2024-003) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2405MN5ADM and 2405MN5MAP, 2024 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2405MN5ADM and 2405MN5MAP Award Period: Year-Ended December 31, 2024 Type of Finding: Significant Deficiency in Internal Control over Compliance Criteria or Specific Requirement: Standard internal control procedures suggest that casefile eligibility determination should have a timely review documented by someone other than the preparer. Condition: During testing of controls over eligibility, it was noted the County did not have adequate internal controls designed to ensure that casefiles were reviewed for correct eligibility determination. Questioned Costs: None. Context: During testing of controls over eligibility casefile reviews, it was noted that there were no reviews for Non-MAGI cases and MAGI cases. Cause: Lack of management oversight. Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: Yes, 2023-005 Recommendation: We recommend the County increase review over casefiles and ensure that there are performed on a periodic basis throughout the year. Views of Responsible Officials: There is no disagreement with the audit finding.
RANDOM MOMENT STUDY EMPLOYEE LISTING (2024-004) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2405MN5ADM and 2405MN5MAP, 2024 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2405MN5ADM and 2405MN5MAP Award Period: Year-Ended December 31, 2024 Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matters Criteria or Specific Requirement: Compliance standards require the County to separate individuals listed on the RMS listing into separate account coding for use on the quarterly reports. Condition: During testing of reporting requirements, it was noted that the County did not have adequate internal controls designed to ensure that the individuals coded to the RMS general ledger accounts were also included on the RMS quarterly listing. Questioned Costs: None. Context: During testing of the Social Service Random Moment Study listing, two of two quarterly reports tested had an individual that was coded to the RMS listing account codes and should not have been. Cause: Lack of management oversight. Effect: There is minimal effect on the programs. Due to the funding structure, the random moment studies are only used to determine the allocation percentages to the various federal programs and not to determine the total amount of reimbursements. Repeat Finding: No Recommendation: We recommend the County review the RMS listings and employees within the department and account codes to ensure the proper employees are included on the listing and general ledger accounts. Views of Responsible Officials: There is no disagreement with the audit finding
RANDOM MOMENT STUDY EMPLOYEE LISTING (2024-004) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2405MN5ADM and 2405MN5MAP, 2024 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2405MN5ADM and 2405MN5MAP Award Period: Year-Ended December 31, 2024 Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matters Criteria or Specific Requirement: Compliance standards require the County to separate individuals listed on the RMS listing into separate account coding for use on the quarterly reports. Condition: During testing of reporting requirements, it was noted that the County did not have adequate internal controls designed to ensure that the individuals coded to the RMS general ledger accounts were also included on the RMS quarterly listing. Questioned Costs: None. Context: During testing of the Social Service Random Moment Study listing, two of two quarterly reports tested had an individual that was coded to the RMS listing account codes and should not have been. Cause: Lack of management oversight. Effect: There is minimal effect on the programs. Due to the funding structure, the random moment studies are only used to determine the allocation percentages to the various federal programs and not to determine the total amount of reimbursements. Repeat Finding: No Recommendation: We recommend the County review the RMS listings and employees within the department and account codes to ensure the proper employees are included on the listing and general ledger accounts. Views of Responsible Officials: There is no disagreement with the audit finding
RANDOM MOMENT STUDY EMPLOYEE LISTING (2024-004) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2405MN5ADM and 2405MN5MAP, 2024 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2405MN5ADM and 2405MN5MAP Award Period: Year-Ended December 31, 2024 Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matters Criteria or Specific Requirement: Compliance standards require the County to separate individuals listed on the RMS listing into separate account coding for use on the quarterly reports. Condition: During testing of reporting requirements, it was noted that the County did not have adequate internal controls designed to ensure that the individuals coded to the RMS general ledger accounts were also included on the RMS quarterly listing. Questioned Costs: None. Context: During testing of the Social Service Random Moment Study listing, two of two quarterly reports tested had an individual that was coded to the RMS listing account codes and should not have been. Cause: Lack of management oversight. Effect: There is minimal effect on the programs. Due to the funding structure, the random moment studies are only used to determine the allocation percentages to the various federal programs and not to determine the total amount of reimbursements. Repeat Finding: No Recommendation: We recommend the County review the RMS listings and employees within the department and account codes to ensure the proper employees are included on the listing and general ledger accounts. Views of Responsible Officials: There is no disagreement with the audit finding
CONTROLS OVER REPORTING – C&TC ANNUAL REPORT (2024-005) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2405MN5ADM and 2405MN5MAP, 2024 Pass-Through Agency: Brown-Nicollet Community Health Services Pass-Through Numbers: 2405MN5ADM and 2405MN5MAP Award Period: Year-Ended December 31, 2024 Type of Finding: Significant Deficiency in Internal Control Over Compliance Criteria or Specific Requirement: Standard internal control procedures suggest that reports should have a timely review documented by someone other than the preparer. Condition: During testing of reporting requirements, it was noted that the County did not have adequate internal controls designed to ensure that the annual Child and Teen Check-Up (C&TC) report was reviewed prior to submission. Questioned Costs: None. Context: During testing of the annual C&TC report, it was noted that the report was not reviewed by someone other than the preparer. Cause: Lack of management oversight. Effect: The amounts reported could be inaccurate and there is increased risk that the County would not correct it internally. Repeat Finding: No Recommendation: We recommend the County have a secondary person review these reports before they are submitted to DHS. Views of Responsible Officials: There is no disagreement with the audit finding.
CONTROLS OVER REPORTING – C&TC ANNUAL REPORT (2024-005) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2405MN5ADM and 2405MN5MAP, 2024 Pass-Through Agency: Brown-Nicollet Community Health Services Pass-Through Numbers: 2405MN5ADM and 2405MN5MAP Award Period: Year-Ended December 31, 2024 Type of Finding: Significant Deficiency in Internal Control Over Compliance Criteria or Specific Requirement: Standard internal control procedures suggest that reports should have a timely review documented by someone other than the preparer. Condition: During testing of reporting requirements, it was noted that the County did not have adequate internal controls designed to ensure that the annual Child and Teen Check-Up (C&TC) report was reviewed prior to submission. Questioned Costs: None. Context: During testing of the annual C&TC report, it was noted that the report was not reviewed by someone other than the preparer. Cause: Lack of management oversight. Effect: The amounts reported could be inaccurate and there is increased risk that the County would not correct it internally. Repeat Finding: No Recommendation: We recommend the County have a secondary person review these reports before they are submitted to DHS. Views of Responsible Officials: There is no disagreement with the audit finding.
CONTROLS OVER REPORTING – C&TC ANNUAL REPORT (2024-005) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2405MN5ADM and 2405MN5MAP, 2024 Pass-Through Agency: Brown-Nicollet Community Health Services Pass-Through Numbers: 2405MN5ADM and 2405MN5MAP Award Period: Year-Ended December 31, 2024 Type of Finding: Significant Deficiency in Internal Control Over Compliance Criteria or Specific Requirement: Standard internal control procedures suggest that reports should have a timely review documented by someone other than the preparer. Condition: During testing of reporting requirements, it was noted that the County did not have adequate internal controls designed to ensure that the annual Child and Teen Check-Up (C&TC) report was reviewed prior to submission. Questioned Costs: None. Context: During testing of the annual C&TC report, it was noted that the report was not reviewed by someone other than the preparer. Cause: Lack of management oversight. Effect: The amounts reported could be inaccurate and there is increased risk that the County would not correct it internally. Repeat Finding: No Recommendation: We recommend the County have a secondary person review these reports before they are submitted to DHS. Views of Responsible Officials: There is no disagreement with the audit finding.