Audit 412568

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(s) and Year: 2505MN5ADM & 2505MN5MAP – 2025 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Number(s): 2505MN5ADM & 2505MN5MAP Award Period: Year-Ended December 31, 2025 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matters Criteria or specific requirement: The County is required to review clients’ applications annually and retain that documentation whether the case is transferred to another County. Applications are also required to be complete. Condition: During testing of 60 MAGI and non-MAGI casefiles, one of eight non-MAGI casefiles reviewed did not contain sufficient documentation to support that required asset and income verification procedures were performed. Questioned Costs: None Context: For one of the eight non-MAGI casefiles tested, it was noted that one casefile did not include the required asset and income verification. Effect: An ineligible individual may receive benefits. Repeat Finding: Not applicable. Recommendation: We recommend the County implement procedures to ensure all required documentation is maintained on file. 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(s) and Year: 2505MN5ADM & 2505MN5MAP – 2025 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Number(s): 2505MN5ADM & 2505MN5MAP Award Period: Year-Ended December 31, 2025 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Control over Compliance Criteria or specific requirement: Non-federal entities are required to establish, document, and maintain effective internal controls over federal awards that provide reasonable assurance that the entity is managing the award in compliance with federal statutes, regulations, and the terms and conditions of the award. Management should establish and operate monitoring activities to monitor the internal control system and evaluate the results. Because eligibility is a direct and material compliance requirement for the Medicaid Cluster, internal review procedures over eligibility casefiles are an important control to help ensure required procedures are completed and documented. Condition: There is an absence of internal reviews over casefiles. Without an effective review process, missing or incomplete verification support may not be detected, increasing the risk of noncompliance with eligibility requirements and unsupported benefit determinations. Questioned Costs: None Context: There is an absence of internal reviews over casefiles. Without an effective review process, missing or incomplete verification support may not be detected, increasing the risk of noncompliance with eligibility requirements and unsupported benefit determinations. Effect: The County is not in compliance with requirements for eligibility and controls are not operating effectively. Repeat Finding: Not applicable. Recommendation: We recommend the County management implement formal internal review procedures over casefiles to ensure required procedures are completed and adequately documented. Views of responsible officials: There is no disagreement with the audit finding.