Audit 403603

Condition: Four out of twenty-five participant files tested were either missing documentation or contained inadequate documentation to support the participant's eligibility. Criteria: Proper documentation should be obtained and retained in participants' files to support their eligibility. Cause: The contracted service provider was either not able to obtain necessary documentation or obtained incorrect support documentation regarding eligibility. Effect: There is potential that ineligible participants will be provided services. Recommendation: A list of appropriate documentation to support eligibility should be created and maintained in each file. All attempts should be made to obtain necessary documentation and all support should be retained in the participant's file.

Condition: All twenty-five participant files tested either only included one signature or lacked signatures to evidence segregation of duties around approval and review of the participant's eligibility. Criteria: There should be a segregation between the approval and review of a participant's eligibility for the program. Cause: The contract provider did not sign off on necessary form or the forms lacked necessary signatures to evidence segregation of duties between approval and review. Effect: There is potential that ineligible participants will be provided services. Recommendation: The client should make sure that all forms are appropriately signed by the necessary individuals.