Audit 52858

FY End
2022-06-30
Total Expended
$9.20B
Findings
26
Programs
29
Year: 2022 Accepted: 2023-02-08
Auditor: Moss Adams LLP

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
46057 2022-002 Significant Deficiency Yes L
50480 2022-002 Significant Deficiency Yes L
50481 2022-002 Significant Deficiency - L
50482 2022-002 Significant Deficiency - L
50483 2022-002 Significant Deficiency - L
50484 2022-002 Significant Deficiency - L
50485 2022-002 Significant Deficiency - L
50486 2022-003 Significant Deficiency - N
50487 2022-003 Significant Deficiency - N
50488 2022-003 Significant Deficiency - N
50489 2022-003 Significant Deficiency - N
50490 2022-003 Significant Deficiency - N
50491 2022-003 Significant Deficiency - N
622499 2022-002 Significant Deficiency Yes L
626922 2022-002 Significant Deficiency Yes L
626923 2022-002 Significant Deficiency - L
626924 2022-002 Significant Deficiency - L
626925 2022-002 Significant Deficiency - L
626926 2022-002 Significant Deficiency - L
626927 2022-002 Significant Deficiency - L
626928 2022-003 Significant Deficiency - N
626929 2022-003 Significant Deficiency - N
626930 2022-003 Significant Deficiency - N
626931 2022-003 Significant Deficiency - N
626932 2022-003 Significant Deficiency - N
626933 2022-003 Significant Deficiency - N

Programs

ALN Program Spent Major Findings
10.551 Supplemental Nutrition Assistance Program $1.50B Yes 0
10.542 Pandemic Ebt Food Benefits $212.54M Yes 0
93.767 Children's Health Insurance Program $104.67M - 0
93.563 Child Support Enforcement $30.47M - 0
10.555 National School Lunch Program $14.33M - 0
10.569 Emergency Food Assistance Program (food Commodities) $12.86M - 0
21.027 Coronavirus State and Local Fiscal Recovery Funds $11.42M - 0
93.788 Opioid Str $6.61M - 0
93.558 Temporary Assistance for Needy Families $6.31M - 1
93.778 Medical Assistance Program $6.17M Yes 1
10.565 Commodity Supplemental Food Program $4.25M - 0
10.649 Pandemic Ebt Administrative Costs $3.67M - 0
93.777 State Survey and Certification of Health Care Providers and Suppliers (title Xviii) Medicare $1.91M Yes 1
93.566 Refugee and Entrant Assistance_state Administered Programs $1.69M - 0
93.665 Emergency Grants to Address Mental and Substance Use Disorders During Covid-19 $1.62M - 0
93.959 Block Grants for Prevention and Treatment of Substance Abuse $1.48M - 0
16.838 Comprehensive Opioid Abuse Site-Based Program $1.10M - 0
93.568 Low-Income Home Energy Assistance $910,706 Yes 1
93.958 Block Grants for Community Mental Health Services $850,139 - 0
10.568 Emergency Food Assistance Program (administrative Costs) $779,940 - 0
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $547,500 Yes 0
10.580 Supplemental Nutrition Assistance Program, Process and Technology Improvement Grants $518,558 - 0
93.569 Community Services Block Grant $492,268 - 0
93.150 Projects for Assistance in Transition From Homelessness (path) $320,698 - 0
10.560 State Administrative Expenses for Child Nutrition $308,364 - 0
93.639 Aca-Transforming Clinical Practice Initiative: Support and Alignment Networks (sans) $162,334 - 0
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $141,957 - 0
93.664 Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment (support) for Patients and Communities Act (b) $138,958 - 0
97.032 Crisis Counseling $37,340 - 0

Contacts

Name Title Type
K49NN52HU4L7 Carolee Graham Auditee
5054901055 Kory Hoggan Auditor
No contacts on file

Notes to SEFA

Title: Note 2: Basis of Accounting Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the federalaward activity of the State of New Mexico Human Services Department (the Department) under programsof the federal government for the year ended June 30, 2022. The information in this Schedule ispresented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200,Uniform Administrative Requirements, Cost Principles, and Audit Requirements of Federal Awards(Uniform Guidance). Because the Schedule presents only a selected portion of the operations of theDepartment, it is not intended to and does not present the financial position or changes in net position ofthe Department. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Expenditures reported on the Schedule are reported on the modified accrual basis of accounting. Suchexpenditures are recognized following the cost principles contained in the Uniform Guidance, whereascertain types of expenditures are not allowable or are limited as to reimbursement.
Title: Note 3: Non-Cash Federal Assistance Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the federalaward activity of the State of New Mexico Human Services Department (the Department) under programsof the federal government for the year ended June 30, 2022. The information in this Schedule ispresented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200,Uniform Administrative Requirements, Cost Principles, and Audit Requirements of Federal Awards(Uniform Guidance). Because the Schedule presents only a selected portion of the operations of theDepartment, it is not intended to and does not present the financial position or changes in net position ofthe Department. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The Department receives USDA Commodities for use in sponsoring the Food Distribution Clusterprograms. The value of commodities received for the year ended June 30, 2022 was $18,378,313 and isreported in the Schedule of Expenditures of Federal Awards under the Commodity Supplemental FoodProgram and the Emergency Food Assistance Program, federal assistance listing numbers 10.565 and10.569.
Title: Note 4: Reconciliation to Financial Statements Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the federalaward activity of the State of New Mexico Human Services Department (the Department) under programsof the federal government for the year ended June 30, 2022. The information in this Schedule ispresented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200,Uniform Administrative Requirements, Cost Principles, and Audit Requirements of Federal Awards(Uniform Guidance). Because the Schedule presents only a selected portion of the operations of theDepartment, it is not intended to and does not present the financial position or changes in net position ofthe Department. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Federal Grant Revenue, per Statement of Revenues, Expenditures, andChanges in Fund Balance $ 9,204,558,866Federal Grant Revenue not Directly Related to Grant Expenditures (5,287,889)Miscellaneous Adjustments (2,346,512)Federal Grant Expenditures, per Statement of Expenditures of Federal Awards $ 9,196,924,465

Finding Details

Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition: Required screening and license verification for 10 of 25 providers tested was not properly supported by the Department's records. Criteria: 42 CFR 455.410 states that the State Medicaid agency must require all enrolled providers to be screened. Per 42 CFR 455.412, the agency must verify the provider?s license has not expired and is valid. Context: A sample of 25 out of approximately 25,000 providers who received payment during the year were tested to determine whether required screening was performed before the provider was enrolled. For one provider out of 25 providers tested for compliance, the Department was not able to provide evidence that the provider was properly screened before being enrolled. For one out of 25 providers tested, the Department was not able to provide evidence that the provider?s license was verified. For 8 of 25 providers tested, the Department was not able to provide documentation that the required screening was performed. Cause: Although the Department has policies and procedures in place to ensure the proper forms and documentation is maintained, the Department depends on third-party vendors to perform various provider screenings. The screenings performed by the third-party vendor were not kept by the Department. Effect: There is no documentation to show that a provider screening and license verification was conducted to show compliance with Medicaid requirements. Questioned Cost: Unknown Repeat Finding: This is not a repeat finding. Recommendation: We recommend that the Department review and update controls to ensure proper screening and license verification is performed for all providers and that documentation of the screening and verification is retained in all cases. Current Status/Plan of Action: MAD continues to work with its third-party vendor to determine whether the providers? documentation was maintained in the legacy system prior to the transfer of records into the current MMIS system. A corrective action will be developed once the root cause analysis is completed. The Program intends to complete corrective actions by the end of fiscal year 2023. Responsible Person: MAD Compliance Officer, Julie Lovato and PPSB Bureau Chief, Tashi Gyalkhar.
Condition: Required screening and license verification for 10 of 25 providers tested was not properly supported by the Department's records. Criteria: 42 CFR 455.410 states that the State Medicaid agency must require all enrolled providers to be screened. Per 42 CFR 455.412, the agency must verify the provider?s license has not expired and is valid. Context: A sample of 25 out of approximately 25,000 providers who received payment during the year were tested to determine whether required screening was performed before the provider was enrolled. For one provider out of 25 providers tested for compliance, the Department was not able to provide evidence that the provider was properly screened before being enrolled. For one out of 25 providers tested, the Department was not able to provide evidence that the provider?s license was verified. For 8 of 25 providers tested, the Department was not able to provide documentation that the required screening was performed. Cause: Although the Department has policies and procedures in place to ensure the proper forms and documentation is maintained, the Department depends on third-party vendors to perform various provider screenings. The screenings performed by the third-party vendor were not kept by the Department. Effect: There is no documentation to show that a provider screening and license verification was conducted to show compliance with Medicaid requirements. Questioned Cost: Unknown Repeat Finding: This is not a repeat finding. Recommendation: We recommend that the Department review and update controls to ensure proper screening and license verification is performed for all providers and that documentation of the screening and verification is retained in all cases. Current Status/Plan of Action: MAD continues to work with its third-party vendor to determine whether the providers? documentation was maintained in the legacy system prior to the transfer of records into the current MMIS system. A corrective action will be developed once the root cause analysis is completed. The Program intends to complete corrective actions by the end of fiscal year 2023. Responsible Person: MAD Compliance Officer, Julie Lovato and PPSB Bureau Chief, Tashi Gyalkhar.
Condition: Required screening and license verification for 10 of 25 providers tested was not properly supported by the Department's records. Criteria: 42 CFR 455.410 states that the State Medicaid agency must require all enrolled providers to be screened. Per 42 CFR 455.412, the agency must verify the provider?s license has not expired and is valid. Context: A sample of 25 out of approximately 25,000 providers who received payment during the year were tested to determine whether required screening was performed before the provider was enrolled. For one provider out of 25 providers tested for compliance, the Department was not able to provide evidence that the provider was properly screened before being enrolled. For one out of 25 providers tested, the Department was not able to provide evidence that the provider?s license was verified. For 8 of 25 providers tested, the Department was not able to provide documentation that the required screening was performed. Cause: Although the Department has policies and procedures in place to ensure the proper forms and documentation is maintained, the Department depends on third-party vendors to perform various provider screenings. The screenings performed by the third-party vendor were not kept by the Department. Effect: There is no documentation to show that a provider screening and license verification was conducted to show compliance with Medicaid requirements. Questioned Cost: Unknown Repeat Finding: This is not a repeat finding. Recommendation: We recommend that the Department review and update controls to ensure proper screening and license verification is performed for all providers and that documentation of the screening and verification is retained in all cases. Current Status/Plan of Action: MAD continues to work with its third-party vendor to determine whether the providers? documentation was maintained in the legacy system prior to the transfer of records into the current MMIS system. A corrective action will be developed once the root cause analysis is completed. The Program intends to complete corrective actions by the end of fiscal year 2023. Responsible Person: MAD Compliance Officer, Julie Lovato and PPSB Bureau Chief, Tashi Gyalkhar.
Condition: Required screening and license verification for 10 of 25 providers tested was not properly supported by the Department's records. Criteria: 42 CFR 455.410 states that the State Medicaid agency must require all enrolled providers to be screened. Per 42 CFR 455.412, the agency must verify the provider?s license has not expired and is valid. Context: A sample of 25 out of approximately 25,000 providers who received payment during the year were tested to determine whether required screening was performed before the provider was enrolled. For one provider out of 25 providers tested for compliance, the Department was not able to provide evidence that the provider was properly screened before being enrolled. For one out of 25 providers tested, the Department was not able to provide evidence that the provider?s license was verified. For 8 of 25 providers tested, the Department was not able to provide documentation that the required screening was performed. Cause: Although the Department has policies and procedures in place to ensure the proper forms and documentation is maintained, the Department depends on third-party vendors to perform various provider screenings. The screenings performed by the third-party vendor were not kept by the Department. Effect: There is no documentation to show that a provider screening and license verification was conducted to show compliance with Medicaid requirements. Questioned Cost: Unknown Repeat Finding: This is not a repeat finding. Recommendation: We recommend that the Department review and update controls to ensure proper screening and license verification is performed for all providers and that documentation of the screening and verification is retained in all cases. Current Status/Plan of Action: MAD continues to work with its third-party vendor to determine whether the providers? documentation was maintained in the legacy system prior to the transfer of records into the current MMIS system. A corrective action will be developed once the root cause analysis is completed. The Program intends to complete corrective actions by the end of fiscal year 2023. Responsible Person: MAD Compliance Officer, Julie Lovato and PPSB Bureau Chief, Tashi Gyalkhar.
Condition: Required screening and license verification for 10 of 25 providers tested was not properly supported by the Department's records. Criteria: 42 CFR 455.410 states that the State Medicaid agency must require all enrolled providers to be screened. Per 42 CFR 455.412, the agency must verify the provider?s license has not expired and is valid. Context: A sample of 25 out of approximately 25,000 providers who received payment during the year were tested to determine whether required screening was performed before the provider was enrolled. For one provider out of 25 providers tested for compliance, the Department was not able to provide evidence that the provider was properly screened before being enrolled. For one out of 25 providers tested, the Department was not able to provide evidence that the provider?s license was verified. For 8 of 25 providers tested, the Department was not able to provide documentation that the required screening was performed. Cause: Although the Department has policies and procedures in place to ensure the proper forms and documentation is maintained, the Department depends on third-party vendors to perform various provider screenings. The screenings performed by the third-party vendor were not kept by the Department. Effect: There is no documentation to show that a provider screening and license verification was conducted to show compliance with Medicaid requirements. Questioned Cost: Unknown Repeat Finding: This is not a repeat finding. Recommendation: We recommend that the Department review and update controls to ensure proper screening and license verification is performed for all providers and that documentation of the screening and verification is retained in all cases. Current Status/Plan of Action: MAD continues to work with its third-party vendor to determine whether the providers? documentation was maintained in the legacy system prior to the transfer of records into the current MMIS system. A corrective action will be developed once the root cause analysis is completed. The Program intends to complete corrective actions by the end of fiscal year 2023. Responsible Person: MAD Compliance Officer, Julie Lovato and PPSB Bureau Chief, Tashi Gyalkhar.
Condition: Required screening and license verification for 10 of 25 providers tested was not properly supported by the Department's records. Criteria: 42 CFR 455.410 states that the State Medicaid agency must require all enrolled providers to be screened. Per 42 CFR 455.412, the agency must verify the provider?s license has not expired and is valid. Context: A sample of 25 out of approximately 25,000 providers who received payment during the year were tested to determine whether required screening was performed before the provider was enrolled. For one provider out of 25 providers tested for compliance, the Department was not able to provide evidence that the provider was properly screened before being enrolled. For one out of 25 providers tested, the Department was not able to provide evidence that the provider?s license was verified. For 8 of 25 providers tested, the Department was not able to provide documentation that the required screening was performed. Cause: Although the Department has policies and procedures in place to ensure the proper forms and documentation is maintained, the Department depends on third-party vendors to perform various provider screenings. The screenings performed by the third-party vendor were not kept by the Department. Effect: There is no documentation to show that a provider screening and license verification was conducted to show compliance with Medicaid requirements. Questioned Cost: Unknown Repeat Finding: This is not a repeat finding. Recommendation: We recommend that the Department review and update controls to ensure proper screening and license verification is performed for all providers and that documentation of the screening and verification is retained in all cases. Current Status/Plan of Action: MAD continues to work with its third-party vendor to determine whether the providers? documentation was maintained in the legacy system prior to the transfer of records into the current MMIS system. A corrective action will be developed once the root cause analysis is completed. The Program intends to complete corrective actions by the end of fiscal year 2023. Responsible Person: MAD Compliance Officer, Julie Lovato and PPSB Bureau Chief, Tashi Gyalkhar.
Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition/Context: The Department did not meet reporting requirements for Federal Funding Accountability and Transparency Act (FFATA) during the year ended June 30, 2022. No FFATA reporting was submitted during the year ended June 30, 2022. Criteria: Under the requirements of the Federal Funding Accountability and Transparency Act (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252, the Department is required to submit reports to the Federal Funding Accountability and Transparency Act Subaward Reporting System for any subawards of $30,000 or more. Cause: The Department has not implemented the proper controls to ensure all required FFATA reports were submitted to the federal agency. Effect: Reporting requirements were not met for FFATA. Department of Health and Human Services did not receive timely reporting and did not receive all the information as requested from the Department. Repeat Finding: This is a repeat finding. Questioned Costs: None. Recommendation: We recommend that the Department ensure that adequate controls are in place to ensure that report due dates are met, and that reports are reviewed prior to submission to ensure that all required data is included. We further recommend that the reporting data be reviewed internally by someone other than the person preparing the reports. Current Status/Plan of Action: The Income Support Division (ISD) will ensure that the appropriate data is gathered and reported on all TANF funded contracts that meet the threshold as required by the Federal Funding Accountability and Transparency Act (FFATA). ISD will identify the individuals who are responsible for gathering the data and will develop a process to ensure complete and timely submission of this requirement. ISD will also ensure that there are adequate controls in place to review all required data and that the data is reviewed prior to submission and by someone other than the person preparing the report. ASD staff from the Compliance and Administration, Contracts and Procurement and Grants Management Bureau are to work with all Division staff to gather the appropriate data to report and submit the Federal Funding Accountability and Transparency Act (FFATA). ASD needed to fill the Grants Management and the Compliance and Administration Bureau Chiefs to begin working on this process to complete the FFATA report by 6/30/22, as indicated in the prior year planned corrective action, however filling these positions took longer than expected and were not filled till the last quarter of fiscal year 2022. The data will be gathered so HSD can complete and submit the FFATA report by the end of fiscal year 2023 (6/30/2023). Responsible Person: Work and Family Support Bureau Chief, Contracts and Procurement Bureau Chief, Grants Bureau Chief, and Compliance and Administration Bureau Chief.
Condition: Required screening and license verification for 10 of 25 providers tested was not properly supported by the Department's records. Criteria: 42 CFR 455.410 states that the State Medicaid agency must require all enrolled providers to be screened. Per 42 CFR 455.412, the agency must verify the provider?s license has not expired and is valid. Context: A sample of 25 out of approximately 25,000 providers who received payment during the year were tested to determine whether required screening was performed before the provider was enrolled. For one provider out of 25 providers tested for compliance, the Department was not able to provide evidence that the provider was properly screened before being enrolled. For one out of 25 providers tested, the Department was not able to provide evidence that the provider?s license was verified. For 8 of 25 providers tested, the Department was not able to provide documentation that the required screening was performed. Cause: Although the Department has policies and procedures in place to ensure the proper forms and documentation is maintained, the Department depends on third-party vendors to perform various provider screenings. The screenings performed by the third-party vendor were not kept by the Department. Effect: There is no documentation to show that a provider screening and license verification was conducted to show compliance with Medicaid requirements. Questioned Cost: Unknown Repeat Finding: This is not a repeat finding. Recommendation: We recommend that the Department review and update controls to ensure proper screening and license verification is performed for all providers and that documentation of the screening and verification is retained in all cases. Current Status/Plan of Action: MAD continues to work with its third-party vendor to determine whether the providers? documentation was maintained in the legacy system prior to the transfer of records into the current MMIS system. A corrective action will be developed once the root cause analysis is completed. The Program intends to complete corrective actions by the end of fiscal year 2023. Responsible Person: MAD Compliance Officer, Julie Lovato and PPSB Bureau Chief, Tashi Gyalkhar.
Condition: Required screening and license verification for 10 of 25 providers tested was not properly supported by the Department's records. Criteria: 42 CFR 455.410 states that the State Medicaid agency must require all enrolled providers to be screened. Per 42 CFR 455.412, the agency must verify the provider?s license has not expired and is valid. Context: A sample of 25 out of approximately 25,000 providers who received payment during the year were tested to determine whether required screening was performed before the provider was enrolled. For one provider out of 25 providers tested for compliance, the Department was not able to provide evidence that the provider was properly screened before being enrolled. For one out of 25 providers tested, the Department was not able to provide evidence that the provider?s license was verified. For 8 of 25 providers tested, the Department was not able to provide documentation that the required screening was performed. Cause: Although the Department has policies and procedures in place to ensure the proper forms and documentation is maintained, the Department depends on third-party vendors to perform various provider screenings. The screenings performed by the third-party vendor were not kept by the Department. Effect: There is no documentation to show that a provider screening and license verification was conducted to show compliance with Medicaid requirements. Questioned Cost: Unknown Repeat Finding: This is not a repeat finding. Recommendation: We recommend that the Department review and update controls to ensure proper screening and license verification is performed for all providers and that documentation of the screening and verification is retained in all cases. Current Status/Plan of Action: MAD continues to work with its third-party vendor to determine whether the providers? documentation was maintained in the legacy system prior to the transfer of records into the current MMIS system. A corrective action will be developed once the root cause analysis is completed. The Program intends to complete corrective actions by the end of fiscal year 2023. Responsible Person: MAD Compliance Officer, Julie Lovato and PPSB Bureau Chief, Tashi Gyalkhar.
Condition: Required screening and license verification for 10 of 25 providers tested was not properly supported by the Department's records. Criteria: 42 CFR 455.410 states that the State Medicaid agency must require all enrolled providers to be screened. Per 42 CFR 455.412, the agency must verify the provider?s license has not expired and is valid. Context: A sample of 25 out of approximately 25,000 providers who received payment during the year were tested to determine whether required screening was performed before the provider was enrolled. For one provider out of 25 providers tested for compliance, the Department was not able to provide evidence that the provider was properly screened before being enrolled. For one out of 25 providers tested, the Department was not able to provide evidence that the provider?s license was verified. For 8 of 25 providers tested, the Department was not able to provide documentation that the required screening was performed. Cause: Although the Department has policies and procedures in place to ensure the proper forms and documentation is maintained, the Department depends on third-party vendors to perform various provider screenings. The screenings performed by the third-party vendor were not kept by the Department. Effect: There is no documentation to show that a provider screening and license verification was conducted to show compliance with Medicaid requirements. Questioned Cost: Unknown Repeat Finding: This is not a repeat finding. Recommendation: We recommend that the Department review and update controls to ensure proper screening and license verification is performed for all providers and that documentation of the screening and verification is retained in all cases. Current Status/Plan of Action: MAD continues to work with its third-party vendor to determine whether the providers? documentation was maintained in the legacy system prior to the transfer of records into the current MMIS system. A corrective action will be developed once the root cause analysis is completed. The Program intends to complete corrective actions by the end of fiscal year 2023. Responsible Person: MAD Compliance Officer, Julie Lovato and PPSB Bureau Chief, Tashi Gyalkhar.
Condition: Required screening and license verification for 10 of 25 providers tested was not properly supported by the Department's records. Criteria: 42 CFR 455.410 states that the State Medicaid agency must require all enrolled providers to be screened. Per 42 CFR 455.412, the agency must verify the provider?s license has not expired and is valid. Context: A sample of 25 out of approximately 25,000 providers who received payment during the year were tested to determine whether required screening was performed before the provider was enrolled. For one provider out of 25 providers tested for compliance, the Department was not able to provide evidence that the provider was properly screened before being enrolled. For one out of 25 providers tested, the Department was not able to provide evidence that the provider?s license was verified. For 8 of 25 providers tested, the Department was not able to provide documentation that the required screening was performed. Cause: Although the Department has policies and procedures in place to ensure the proper forms and documentation is maintained, the Department depends on third-party vendors to perform various provider screenings. The screenings performed by the third-party vendor were not kept by the Department. Effect: There is no documentation to show that a provider screening and license verification was conducted to show compliance with Medicaid requirements. Questioned Cost: Unknown Repeat Finding: This is not a repeat finding. Recommendation: We recommend that the Department review and update controls to ensure proper screening and license verification is performed for all providers and that documentation of the screening and verification is retained in all cases. Current Status/Plan of Action: MAD continues to work with its third-party vendor to determine whether the providers? documentation was maintained in the legacy system prior to the transfer of records into the current MMIS system. A corrective action will be developed once the root cause analysis is completed. The Program intends to complete corrective actions by the end of fiscal year 2023. Responsible Person: MAD Compliance Officer, Julie Lovato and PPSB Bureau Chief, Tashi Gyalkhar.
Condition: Required screening and license verification for 10 of 25 providers tested was not properly supported by the Department's records. Criteria: 42 CFR 455.410 states that the State Medicaid agency must require all enrolled providers to be screened. Per 42 CFR 455.412, the agency must verify the provider?s license has not expired and is valid. Context: A sample of 25 out of approximately 25,000 providers who received payment during the year were tested to determine whether required screening was performed before the provider was enrolled. For one provider out of 25 providers tested for compliance, the Department was not able to provide evidence that the provider was properly screened before being enrolled. For one out of 25 providers tested, the Department was not able to provide evidence that the provider?s license was verified. For 8 of 25 providers tested, the Department was not able to provide documentation that the required screening was performed. Cause: Although the Department has policies and procedures in place to ensure the proper forms and documentation is maintained, the Department depends on third-party vendors to perform various provider screenings. The screenings performed by the third-party vendor were not kept by the Department. Effect: There is no documentation to show that a provider screening and license verification was conducted to show compliance with Medicaid requirements. Questioned Cost: Unknown Repeat Finding: This is not a repeat finding. Recommendation: We recommend that the Department review and update controls to ensure proper screening and license verification is performed for all providers and that documentation of the screening and verification is retained in all cases. Current Status/Plan of Action: MAD continues to work with its third-party vendor to determine whether the providers? documentation was maintained in the legacy system prior to the transfer of records into the current MMIS system. A corrective action will be developed once the root cause analysis is completed. The Program intends to complete corrective actions by the end of fiscal year 2023. Responsible Person: MAD Compliance Officer, Julie Lovato and PPSB Bureau Chief, Tashi Gyalkhar.
Condition: Required screening and license verification for 10 of 25 providers tested was not properly supported by the Department's records. Criteria: 42 CFR 455.410 states that the State Medicaid agency must require all enrolled providers to be screened. Per 42 CFR 455.412, the agency must verify the provider?s license has not expired and is valid. Context: A sample of 25 out of approximately 25,000 providers who received payment during the year were tested to determine whether required screening was performed before the provider was enrolled. For one provider out of 25 providers tested for compliance, the Department was not able to provide evidence that the provider was properly screened before being enrolled. For one out of 25 providers tested, the Department was not able to provide evidence that the provider?s license was verified. For 8 of 25 providers tested, the Department was not able to provide documentation that the required screening was performed. Cause: Although the Department has policies and procedures in place to ensure the proper forms and documentation is maintained, the Department depends on third-party vendors to perform various provider screenings. The screenings performed by the third-party vendor were not kept by the Department. Effect: There is no documentation to show that a provider screening and license verification was conducted to show compliance with Medicaid requirements. Questioned Cost: Unknown Repeat Finding: This is not a repeat finding. Recommendation: We recommend that the Department review and update controls to ensure proper screening and license verification is performed for all providers and that documentation of the screening and verification is retained in all cases. Current Status/Plan of Action: MAD continues to work with its third-party vendor to determine whether the providers? documentation was maintained in the legacy system prior to the transfer of records into the current MMIS system. A corrective action will be developed once the root cause analysis is completed. The Program intends to complete corrective actions by the end of fiscal year 2023. Responsible Person: MAD Compliance Officer, Julie Lovato and PPSB Bureau Chief, Tashi Gyalkhar.