Audit 367288

Federal Agency: US Department of Health and Human Services Federal Program Name: Medical Assistance Program Assistance Listing Number: 93.778 Federal Award Identification Number and Year: Unknown Pass-Through Agency: Wisconsin Department of Health Services Pass-Through Number(s): WIMCR Award Period: 1/1/2024-12/31/2024 Type of Finding: • Significant Deficiency in Internal Control over Compliance • Other Matter Criteria or Specific Requirement: Review of the report and supporting documentation by someone other than the preparer prior to submitting the report is an internal control intended to prevent or decrease the occurrence of errors. Condition: The County files Wisconsin Medicaid Cost Reporting (WIMCR) annually with the State of Wisconsin. There was no review of the report by someone other than the preparer prior to submission to the state. Questioned Costs: None Context: While performing audit procedures, it was noted that no one reviewed the report prior to submitting the report to the state. This was a finding in the prior year audit and a plan was put into place to address the issue but was not implemented for the 2023 report filed in 2024. Cause: The Department experienced some staffing issues that delayed the implementation of a review process. Effect: Reported expenditures may not reconcile to County's recorded general ledger expenditures and amounts may be over or under reported. Repeat Finding: This finding is a repeat finding. The prior year finding number was 2023-004. Recommendation: We recommend the County develop and implement a process to require review and approval of the WIMCR reports prior to the submission of the report to the state to help ensure that the data reported are accurate, complete and supporting documentation is retained. View of Responsible Officials: There is no disagreement with the audit finding.