Audit 412356

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: 2505MN5ADM and 2505MN5MAP, 2025 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2505MN5ADM and 2505MN5MAP Award Period: Year-Ended December 31, 2025 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, 2024-003 Recommendation: We recommend the County increase review over case files and ensure that they are performed on a periodic basis throughout the year. Views of Responsible Officials: There is no disagreement with the audit finding.

Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Grants to States for Medicaid (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2505MN5ADM and 2505MN5MAP, 2025 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2505MN5ADM and 2505MN5MAP Award Period: Year-Ended December 31, 2025 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 allowable costs and activities 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 properly coded to the RMS listing account codes and was not listed on the RMS quarterly report. 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: Yes, 2024-004 Recommendation: We recommend the County review the RMS listings and employees within the department and account codes to ensure the proper employees are included in the listing and general ledger accounts. Views of Responsible Officials: There is no disagreement with the audit finding.