Audit 388600

Criteria: Per OMB Compliance Supplement 93.558, Compliance Requirement E, 1b(1): Counties must ensure TANF benefits are not provided beyond the 60-month lifetime limit unless an exemption applies (e.g., hardship or extreme cruelty documented under aid code 33). Controls should exist to track cumulative months and terminate benefits when the limit is reached unless proper documentation supports an exemption. Condition: During testing of 40 sampled cases, 1 case was identified where aid code 30 was charged after the 60-month lifetime limit. The noncompliant payments occurred in December 2024, January 2025, and February 2025, totaling $2,652. Questioned costs: $2,652 Context: The TANF program provides temporary financial assistance to eligible families and imposes a 60-month lifetime limit on aid unless an exemption applies, such as hardship or extreme cruelty documented under aid code 33. Counties must monitor cumulative months of aid and terminate benefits when the limit is reached unless proper documentation supports an exemption. In our review of 40 cases, controls generally existed to track the limit and apply exemptions; however, one case continued under aid code 30 beyond the 60-month limit, resulting in noncompliant payments totaling $2,652 for December 2024 through February 2025. Cause: Although controls exist to track the 60-month limit, they were not properly implemented in this instance, allowing benefits to continue beyond the allowable period. Effect: Improper payment of $2,652, which is not material to the program but represents a significant deficiency in internal control. Repeat Finding: This is not a repeat finding. Recommendation: CLA recommends the County strengthen monitoring controls to ensure benefits are terminated promptly upon reaching the 60-month limit unless valid exemptions are documented, implement periodic system audits to detect and prevent similar errors, provide staff training on proper coding and documentation for exemptions such as aid code 33 for hardship or extreme cruelty, and recover improper payments where feasible while reporting corrective actions to the State Department of Social Services. Views of responsible officials: There is no disagreement with the audit finding.

months and ensure verification of information through appropriate systems such as the Income and Eligibility Verification System (IEVS). For non-MAGI beneficiaries, states must renew eligibility at least once every 12 months as described in the Medicaid state plan. Condition: During review of 40 eligibility determinations and redeterminations, we identified two exceptions: one case lacked documentation of IEVS reports required to verify income and eligibility information, and another case had a redetermination completed more than 12 months prior to the active eligibility date, which does not comply with the annual redetermination requirement under 42 CFR 435.916. Questioned costs: None Context: The Medical Assistance Program requires counties to maintain robust eligibility controls to ensure benefits are provided only to qualified individuals. These controls include verifying income and eligibility through systems such as the Income and Eligibility Verification System (IEVS) and conducting annual redeterminations within 12 months of the active eligibility date. Out of 40 eligibility determinations and redeterminations, there are two cases where these controls were not properly implemented, indicating a significant deficiency in internal control. Cause: The deficiencies occurred due to inadequate monitoring and enforcement of established eligibility control procedures by program staff. Effect: Failure to properly implement eligibility controls increases the risk that ineligible individuals may receive benefits under the Medical Assistance Program, potentially resulting in noncompliance with federal requirements and questioned costs. Repeat Finding: This is not a repeat finding. Recommendation: CLA recommends that the County strengthen monitoring procedures to ensure that Income and Eligibility Verification System (IEVS) reports are obtained and retained for all eligibility determinations, implement controls to verify that redeterminations are completed within the required 12- month timeframe prior to the active eligibility date, and provide staff training on compliance requirements and proper documentation standards to reinforce adherence to established policies. Views of responsible officials: There is no disagreement with the audit finding.