Finding 2022-004 Activities Allowed or Unallowed and Allowable Costs/Cost Principles ? Significant Deficiency in Internal Control Over Compliance Agency U.S. Department of the Interior Program Tribal Self-Governance Program Assistance Listing: No. 15.022 Award No. GT-OSGT004 Year 2022 Criteria or Specific Requirement In accordance with 2 CFR section 200.303, the Association is required to establish and maintain effective internal control that provides reasonable assurance that the Association is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. Condition Timesheets were identified that lacked proper approval by an immediate supervisor to support the timesheet approval policy established by the Association. Cause Oversight in following proper procedure around timesheet approval. Effect or potential effect Individuals may directly charge time to the program for unallowed activity. Questioned Costs None Context We tested 16 samples for employees who charged time to the program. For 9 of those samples, timesheets did not contain proper approval as evidenced on the timesheet. Identification as a repeat finding Not applicable. Recommendation All timesheets should be reviewed and approved by an appropriate supervisor prior to processing payroll processing. Views of Responsible Official and Planned Corrective Action Management agrees with finding. The Association will ensure that the proper internal control procedures over timesheets review and approval process are in place before the timesheets are submitted to payroll for processing.
Finding 2022-004 Activities Allowed or Unallowed and Allowable Costs/Cost Principles ? Significant Deficiency in Internal Control Over Compliance Agency U.S. Department of the Interior Program Tribal Self-Governance Program Assistance Listing: No. 15.022 Award No. GT-OSGT004 Year 2022 Criteria or Specific Requirement In accordance with 2 CFR section 200.303, the Association is required to establish and maintain effective internal control that provides reasonable assurance that the Association is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. Condition Timesheets were identified that lacked proper approval by an immediate supervisor to support the timesheet approval policy established by the Association. Cause Oversight in following proper procedure around timesheet approval. Effect or potential effect Individuals may directly charge time to the program for unallowed activity. Questioned Costs None Context We tested 16 samples for employees who charged time to the program. For 9 of those samples, timesheets did not contain proper approval as evidenced on the timesheet. Identification as a repeat finding Not applicable. Recommendation All timesheets should be reviewed and approved by an appropriate supervisor prior to processing payroll processing. Views of Responsible Official and Planned Corrective Action Management agrees with finding. The Association will ensure that the proper internal control procedures over timesheets review and approval process are in place before the timesheets are submitted to payroll for processing.
Finding 2022-003 Eligibility ? Noncompliance and Significant Deficiency in Internal Control Over Compliance Agency U.S. Department of Health and Human Services Program Tribal Self-Governance Program: IHS Compacts/Funding Agreements Assistance Listing: No. 93.210 Award No. 58G950028 Year 2022 Criteria or Specific Requirement In accordance with the IHS funding agreement requirements, as well as Uniform Guidance compliance requirements, the Association is required to maintain documentation of eligibility for the patients receiving medical assistance under the IHS program. Condition The Association was unable to provide proper documentation regarding eligibility of some of the patients for which their accounts were adjusted to the IHS compact. Cause COVID-19 pandemic disrupted established processes. Effect or potential effect Individuals may receive services funded by the IHS program who are ineligible to receive these benefits. Questioned Costs Unknown Context We tested 40 patients who were designated as IHS beneficiaries. For 8 of those patients documentation proving eligibility was not on file. Identification as a repeat finding Was reported as finding 2021-002. Recommendation For all patients receiving services, verification of eligibility should be documented and kept on file electronically. If eligibility documentation is not provided, the hospital needs to attempt to collect on the outstanding balance from the individual or insurance companies, rather than adjusting as an IHS beneficiary. Views of Responsible Official and Planned Corrective Action Management agrees with finding. Monthly audits of the elements of registration, including documentation of beneficiary status will be conducted to ensure continual compliance.
Finding 2022-003 Eligibility ? Noncompliance and Significant Deficiency in Internal Control Over Compliance Agency U.S. Department of Health and Human Services Program Tribal Self-Governance Program: IHS Compacts/Funding Agreements Assistance Listing: No. 93.210 Award No. 58G950028 Year 2022 Criteria or Specific Requirement In accordance with the IHS funding agreement requirements, as well as Uniform Guidance compliance requirements, the Association is required to maintain documentation of eligibility for the patients receiving medical assistance under the IHS program. Condition The Association was unable to provide proper documentation regarding eligibility of some of the patients for which their accounts were adjusted to the IHS compact. Cause COVID-19 pandemic disrupted established processes. Effect or potential effect Individuals may receive services funded by the IHS program who are ineligible to receive these benefits. Questioned Costs Unknown Context We tested 40 patients who were designated as IHS beneficiaries. For 8 of those patients documentation proving eligibility was not on file. Identification as a repeat finding Was reported as finding 2021-002. Recommendation For all patients receiving services, verification of eligibility should be documented and kept on file electronically. If eligibility documentation is not provided, the hospital needs to attempt to collect on the outstanding balance from the individual or insurance companies, rather than adjusting as an IHS beneficiary. Views of Responsible Official and Planned Corrective Action Management agrees with finding. Monthly audits of the elements of registration, including documentation of beneficiary status will be conducted to ensure continual compliance.
Finding 2022-003 Eligibility ? Noncompliance and Significant Deficiency in Internal Control Over Compliance Agency U.S. Department of Health and Human Services Program Tribal Self-Governance Program: IHS Compacts/Funding Agreements Assistance Listing: No. 93.210 Award No. 58G950028 Year 2022 Criteria or Specific Requirement In accordance with the IHS funding agreement requirements, as well as Uniform Guidance compliance requirements, the Association is required to maintain documentation of eligibility for the patients receiving medical assistance under the IHS program. Condition The Association was unable to provide proper documentation regarding eligibility of some of the patients for which their accounts were adjusted to the IHS compact. Cause COVID-19 pandemic disrupted established processes. Effect or potential effect Individuals may receive services funded by the IHS program who are ineligible to receive these benefits. Questioned Costs Unknown Context We tested 40 patients who were designated as IHS beneficiaries. For 8 of those patients documentation proving eligibility was not on file. Identification as a repeat finding Was reported as finding 2021-002. Recommendation For all patients receiving services, verification of eligibility should be documented and kept on file electronically. If eligibility documentation is not provided, the hospital needs to attempt to collect on the outstanding balance from the individual or insurance companies, rather than adjusting as an IHS beneficiary. Views of Responsible Official and Planned Corrective Action Management agrees with finding. Monthly audits of the elements of registration, including documentation of beneficiary status will be conducted to ensure continual compliance.
Finding 2022-003 Eligibility ? Noncompliance and Significant Deficiency in Internal Control Over Compliance Agency U.S. Department of Health and Human Services Program Tribal Self-Governance Program: IHS Compacts/Funding Agreements Assistance Listing: No. 93.210 Award No. 58G950028 Year 2022 Criteria or Specific Requirement In accordance with the IHS funding agreement requirements, as well as Uniform Guidance compliance requirements, the Association is required to maintain documentation of eligibility for the patients receiving medical assistance under the IHS program. Condition The Association was unable to provide proper documentation regarding eligibility of some of the patients for which their accounts were adjusted to the IHS compact. Cause COVID-19 pandemic disrupted established processes. Effect or potential effect Individuals may receive services funded by the IHS program who are ineligible to receive these benefits. Questioned Costs Unknown Context We tested 40 patients who were designated as IHS beneficiaries. For 8 of those patients documentation proving eligibility was not on file. Identification as a repeat finding Was reported as finding 2021-002. Recommendation For all patients receiving services, verification of eligibility should be documented and kept on file electronically. If eligibility documentation is not provided, the hospital needs to attempt to collect on the outstanding balance from the individual or insurance companies, rather than adjusting as an IHS beneficiary. Views of Responsible Official and Planned Corrective Action Management agrees with finding. Monthly audits of the elements of registration, including documentation of beneficiary status will be conducted to ensure continual compliance.
Finding 2022-004 Activities Allowed or Unallowed and Allowable Costs/Cost Principles ? Significant Deficiency in Internal Control Over Compliance Agency U.S. Department of the Interior Program Tribal Self-Governance Program Assistance Listing: No. 15.022 Award No. GT-OSGT004 Year 2022 Criteria or Specific Requirement In accordance with 2 CFR section 200.303, the Association is required to establish and maintain effective internal control that provides reasonable assurance that the Association is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. Condition Timesheets were identified that lacked proper approval by an immediate supervisor to support the timesheet approval policy established by the Association. Cause Oversight in following proper procedure around timesheet approval. Effect or potential effect Individuals may directly charge time to the program for unallowed activity. Questioned Costs None Context We tested 16 samples for employees who charged time to the program. For 9 of those samples, timesheets did not contain proper approval as evidenced on the timesheet. Identification as a repeat finding Not applicable. Recommendation All timesheets should be reviewed and approved by an appropriate supervisor prior to processing payroll processing. Views of Responsible Official and Planned Corrective Action Management agrees with finding. The Association will ensure that the proper internal control procedures over timesheets review and approval process are in place before the timesheets are submitted to payroll for processing.
Finding 2022-004 Activities Allowed or Unallowed and Allowable Costs/Cost Principles ? Significant Deficiency in Internal Control Over Compliance Agency U.S. Department of the Interior Program Tribal Self-Governance Program Assistance Listing: No. 15.022 Award No. GT-OSGT004 Year 2022 Criteria or Specific Requirement In accordance with 2 CFR section 200.303, the Association is required to establish and maintain effective internal control that provides reasonable assurance that the Association is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. Condition Timesheets were identified that lacked proper approval by an immediate supervisor to support the timesheet approval policy established by the Association. Cause Oversight in following proper procedure around timesheet approval. Effect or potential effect Individuals may directly charge time to the program for unallowed activity. Questioned Costs None Context We tested 16 samples for employees who charged time to the program. For 9 of those samples, timesheets did not contain proper approval as evidenced on the timesheet. Identification as a repeat finding Not applicable. Recommendation All timesheets should be reviewed and approved by an appropriate supervisor prior to processing payroll processing. Views of Responsible Official and Planned Corrective Action Management agrees with finding. The Association will ensure that the proper internal control procedures over timesheets review and approval process are in place before the timesheets are submitted to payroll for processing.
Finding 2022-003 Eligibility ? Noncompliance and Significant Deficiency in Internal Control Over Compliance Agency U.S. Department of Health and Human Services Program Tribal Self-Governance Program: IHS Compacts/Funding Agreements Assistance Listing: No. 93.210 Award No. 58G950028 Year 2022 Criteria or Specific Requirement In accordance with the IHS funding agreement requirements, as well as Uniform Guidance compliance requirements, the Association is required to maintain documentation of eligibility for the patients receiving medical assistance under the IHS program. Condition The Association was unable to provide proper documentation regarding eligibility of some of the patients for which their accounts were adjusted to the IHS compact. Cause COVID-19 pandemic disrupted established processes. Effect or potential effect Individuals may receive services funded by the IHS program who are ineligible to receive these benefits. Questioned Costs Unknown Context We tested 40 patients who were designated as IHS beneficiaries. For 8 of those patients documentation proving eligibility was not on file. Identification as a repeat finding Was reported as finding 2021-002. Recommendation For all patients receiving services, verification of eligibility should be documented and kept on file electronically. If eligibility documentation is not provided, the hospital needs to attempt to collect on the outstanding balance from the individual or insurance companies, rather than adjusting as an IHS beneficiary. Views of Responsible Official and Planned Corrective Action Management agrees with finding. Monthly audits of the elements of registration, including documentation of beneficiary status will be conducted to ensure continual compliance.
Finding 2022-003 Eligibility ? Noncompliance and Significant Deficiency in Internal Control Over Compliance Agency U.S. Department of Health and Human Services Program Tribal Self-Governance Program: IHS Compacts/Funding Agreements Assistance Listing: No. 93.210 Award No. 58G950028 Year 2022 Criteria or Specific Requirement In accordance with the IHS funding agreement requirements, as well as Uniform Guidance compliance requirements, the Association is required to maintain documentation of eligibility for the patients receiving medical assistance under the IHS program. Condition The Association was unable to provide proper documentation regarding eligibility of some of the patients for which their accounts were adjusted to the IHS compact. Cause COVID-19 pandemic disrupted established processes. Effect or potential effect Individuals may receive services funded by the IHS program who are ineligible to receive these benefits. Questioned Costs Unknown Context We tested 40 patients who were designated as IHS beneficiaries. For 8 of those patients documentation proving eligibility was not on file. Identification as a repeat finding Was reported as finding 2021-002. Recommendation For all patients receiving services, verification of eligibility should be documented and kept on file electronically. If eligibility documentation is not provided, the hospital needs to attempt to collect on the outstanding balance from the individual or insurance companies, rather than adjusting as an IHS beneficiary. Views of Responsible Official and Planned Corrective Action Management agrees with finding. Monthly audits of the elements of registration, including documentation of beneficiary status will be conducted to ensure continual compliance.
Finding 2022-003 Eligibility ? Noncompliance and Significant Deficiency in Internal Control Over Compliance Agency U.S. Department of Health and Human Services Program Tribal Self-Governance Program: IHS Compacts/Funding Agreements Assistance Listing: No. 93.210 Award No. 58G950028 Year 2022 Criteria or Specific Requirement In accordance with the IHS funding agreement requirements, as well as Uniform Guidance compliance requirements, the Association is required to maintain documentation of eligibility for the patients receiving medical assistance under the IHS program. Condition The Association was unable to provide proper documentation regarding eligibility of some of the patients for which their accounts were adjusted to the IHS compact. Cause COVID-19 pandemic disrupted established processes. Effect or potential effect Individuals may receive services funded by the IHS program who are ineligible to receive these benefits. Questioned Costs Unknown Context We tested 40 patients who were designated as IHS beneficiaries. For 8 of those patients documentation proving eligibility was not on file. Identification as a repeat finding Was reported as finding 2021-002. Recommendation For all patients receiving services, verification of eligibility should be documented and kept on file electronically. If eligibility documentation is not provided, the hospital needs to attempt to collect on the outstanding balance from the individual or insurance companies, rather than adjusting as an IHS beneficiary. Views of Responsible Official and Planned Corrective Action Management agrees with finding. Monthly audits of the elements of registration, including documentation of beneficiary status will be conducted to ensure continual compliance.
Finding 2022-003 Eligibility ? Noncompliance and Significant Deficiency in Internal Control Over Compliance Agency U.S. Department of Health and Human Services Program Tribal Self-Governance Program: IHS Compacts/Funding Agreements Assistance Listing: No. 93.210 Award No. 58G950028 Year 2022 Criteria or Specific Requirement In accordance with the IHS funding agreement requirements, as well as Uniform Guidance compliance requirements, the Association is required to maintain documentation of eligibility for the patients receiving medical assistance under the IHS program. Condition The Association was unable to provide proper documentation regarding eligibility of some of the patients for which their accounts were adjusted to the IHS compact. Cause COVID-19 pandemic disrupted established processes. Effect or potential effect Individuals may receive services funded by the IHS program who are ineligible to receive these benefits. Questioned Costs Unknown Context We tested 40 patients who were designated as IHS beneficiaries. For 8 of those patients documentation proving eligibility was not on file. Identification as a repeat finding Was reported as finding 2021-002. Recommendation For all patients receiving services, verification of eligibility should be documented and kept on file electronically. If eligibility documentation is not provided, the hospital needs to attempt to collect on the outstanding balance from the individual or insurance companies, rather than adjusting as an IHS beneficiary. Views of Responsible Official and Planned Corrective Action Management agrees with finding. Monthly audits of the elements of registration, including documentation of beneficiary status will be conducted to ensure continual compliance.