Corrective Action Plans

Browse how organizations respond to audit findings

Total CAPs
59,856
In database
Filtered Results
10,398
Matching current filters
Showing Page
1 of 416
25 per page

Filters

Clear
This finding is due to the Village not having formal written policies in place required by Uniform Guidance. The Village is aware that these policies are required and will adopt all necessary policies. The Village does not believe that there were any actual nonallowable costs or transactions because...
This finding is due to the Village not having formal written policies in place required by Uniform Guidance. The Village is aware that these policies are required and will adopt all necessary policies. The Village does not believe that there were any actual nonallowable costs or transactions because of the lack of written policies as required by Uniform Guidance. The Village will adopt all necessary policies to be in compliance. The person responsible for the corrective action is the Village President. The anticipated completion date of the corrective action plan is before the end of the 2027 fiscal year. The plan for adherence is the Council will review all proposed policies and adopt them, the Council will also monitor any changes to policy requirements to ensure that they are in compliance in the future.
Finding 2026-001 – Internal Control over Financial Reporting – Allowable Costs U.S. Department of Treasury Passed Through the County of Erie COVID-19: Coronavirus State and Local Fiscal Recovery Funds, ALN 21.027 Allowable Costs Contact Person Responsible for Corrective Action: Name: Tammi Michali T...
Finding 2026-001 – Internal Control over Financial Reporting – Allowable Costs U.S. Department of Treasury Passed Through the County of Erie COVID-19: Coronavirus State and Local Fiscal Recovery Funds, ALN 21.027 Allowable Costs Contact Person Responsible for Corrective Action: Name: Tammi Michali Title: Office Manager Phone/Email: 814-897-2690 / tmichali@ecgra.org Auditor’s Recommendation: The auditors recommend that management implement procedures to ensure all disbursements charged to federal programs are formally reviewed and approved by the Board, or by a properly designated approver, and that such approval is evidenced in writing and maintained with the supporting disbursement documentation. Management should also implement a monitoring procedure to identify any disbursements processed without timely approval and ensure corrective action is taken. Corrective Action Plan: A resolution was passed by the Erie County Gaming Revenue Authority’s Board of Directors affirming their consent to disburse funds for Round 2 of the Educator Retention Awards. The Board was informed by the executive director that this was a clerical oversight as the action to fund Round 2 had been discussed and was given verbal approval at previous Strategic Planning meetings. Anticipated Completion Date: Corrective Action Plan was completed on May 21, 2026
Recommendation: The Center should develop policies and procedures to help ensure pay rates are consistent with supporting employee agreements or other management-approved documentation. Corrective Action Taken: 1. Immediate Review and Correction Upon identification of the finding, the Center conduct...
Recommendation: The Center should develop policies and procedures to help ensure pay rates are consistent with supporting employee agreements or other management-approved documentation. Corrective Action Taken: 1. Immediate Review and Correction Upon identification of the finding, the Center conducted a comprehensive internal audit of pay rates for all employees hired from January 1, 2025, to the present. Any discrepancies identified during this review were promptly corrected to ensure alignment with approved documentation. 2. Staff Training Targeted training will be provided to all Human Resources and Payroll staff. This training will emphasize: The importance of accuracy in data entry and the use of self-review as a quality control tool; Accountability at both the individual and team levels for maintaining complete and accurate payroll data; and Proper preparation and retention of documentation supporting initial payroll entries and any subsequent changes. 3. Policy and Procedure Review The Center has performed a comprehensive review of its internal policies and procedures to: Ensure clear delineation of roles and responsibilities across hiring, onboarding, and payroll processes; and Provide detailed guidance on required documentation to support each step in these processes. 4. Double-Verification Process Management has reinforced a culture of shared accountability by implementing a doubleverification process. This includes: Requiring staff to review and confirm the accuracy of their own work prior to submission; and Requiring receiving staff to independently verify information and resolve any discrepancies before proceeding with further processing. 5. Continued Monitoring In addition to standard bi-weekly payroll reviews conducted by management, the Center will implement quarterly payroll system audits. These audits will verify that all payroll changes are accurate, properly documented, and supported by appropriate approvals.
Federal Program: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Assistance Listing No. 10.557 Recommendation: Our auditors recommended the Organization update its grant allocation process and controls to ensure accurate documentation of expenditures allocated to the gr...
Federal Program: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Assistance Listing No. 10.557 Recommendation: Our auditors recommended the Organization update its grant allocation process and controls to ensure accurate documentation of expenditures allocated to the grant are retained and accurate fringe benefit costs incurred during the month are used to calculate the allocations. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Organization has updated the grant allocation process and controls to ensure accurate documentation of expenditures allocated to the grant are retained and accurate fringe benefit costs incurred during the month are used to calculate the allocations. As part of this update management has reassigned responsibilities for various grants to ensure the process is followed.
Remaining balance was deposited on April 16, 2026. In the future management will ensure deposits are made timely or obtain HUD appproval permitting delay if there were cash flows issues.
Remaining balance was deposited on April 16, 2026. In the future management will ensure deposits are made timely or obtain HUD appproval permitting delay if there were cash flows issues.
Criteria: The objective of the Assistance Listing 93.912 is to improve services for substance use disorder (SUD) and opioid use disorder (OUD) through prevention, treatment, and recovery services. Management is responsible for establishing and maintaining internal controls, including formal policies...
Criteria: The objective of the Assistance Listing 93.912 is to improve services for substance use disorder (SUD) and opioid use disorder (OUD) through prevention, treatment, and recovery services. Management is responsible for establishing and maintaining internal controls, including formal policies and procedures for the review and approval of journal entries, adjustments to expenditures, and account reconciliations, to ensure expenditures reported to granting agencies are complete, accurate, allowable, and properly supported. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Containment -Once we were made aware of this finding through the audit, we began thinking of the most efficient way to document the Board’s knowledge and approvals of journal entries, including adjustments to expenditures and account reconciliations. Root Cause -HOPE is currently revising all policies and procedures. This was HOPE’s first federal single audit, so once we heard of the finding we prioritized revisions of fiscal policies and procedures to address the finding. Action Taken- The first board meeting after learning of this finding will be held on July 27th, 2026. Beginning with that meeting, the Board’s approval of the statement of activity detail, consisting of all charges and journal entries entered into HOPE’s accounting system since the date of the last Board meeting, will be approved via motion and seconded and noted as such in the Board meeting minutes. Most journal entries made during the month are currently entered into the system by HOPE’s CPA. The remaining journal entries are entered by HOPE’s Executive Director. To ensure that the Board is aware of the adjustments made in the system, all journal entries made since the last Board meeting will be approved via a motion and a second as a separate agenda item to ensure that the Board is reviewing these items particularly. All approvals will be noted in the Board meeting minutes. The list of journal entries viewed during the meeting will be initialed by a Board member and kept on file as documentation of internal controls.
Criteria: The objective of Assistance Listing 93.912, Rural Healthcare Services Programs, is to improve access to and delivery of rural health care services, including prevention, treatment, and recovery services. The Organization’s fiscal policies require expenditures to be approved in advance to e...
Criteria: The objective of Assistance Listing 93.912, Rural Healthcare Services Programs, is to improve access to and delivery of rural health care services, including prevention, treatment, and recovery services. The Organization’s fiscal policies require expenditures to be approved in advance to ensure adequate financial resources are available. The policies also require all checks to include two signatures, one of which must be an authorized Board member; purchases of non-expendable personal property and other purchases or contracts exceeding $5,000 to be supported by three competitive quotes; and all nonrecurring expenditures to be approved at least monthly. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Containment - Once we were made aware of this finding through the audit, we determined that we need to find a more effective way to document the Board’s knowledge and approvals of expenditures. Root Cause -HOPE is currently revising all policies and procedures. This was HOPE’s first federal single audit, so once we heard of the finding we prioritized revisions of fiscal policies and procedures to address the finding. Action Taken- The first board meeting after learning of this finding will be held on July 27th, 2026. Beginning with that meeting, the Board’s approval of the Statement of Activity Detail, consisting of all charges and journal entries entered into HOPE’s accounting system since the date of the last Board meeting, will be approved via motion and seconded and noted as such in the Board meeting minutes.
Management has provided a template, which was reviewed and approved by the CFO in April 2026, to the AP Clerk without any roundings of the allocation percentages. Management will review the calculations between January 1 and April 2026 that were used for allocations and will correct any allocations ...
Management has provided a template, which was reviewed and approved by the CFO in April 2026, to the AP Clerk without any roundings of the allocation percentages. Management will review the calculations between January 1 and April 2026 that were used for allocations and will correct any allocations as necessary. Management will ensure the review of expenses include all calculations supporting the expense amounts. All these actions are effective January 1, 2026, and will be managed by the Chief Financial Officer.
Management has strengthened internal controls over payroll processing and timecard approvals. Effective January 1, 2026, prior to processing each payroll, the Organization downloads a complete file of timesheet hours by employee, hour type, and cost center and compares the data against the contractu...
Management has strengthened internal controls over payroll processing and timecard approvals. Effective January 1, 2026, prior to processing each payroll, the Organization downloads a complete file of timesheet hours by employee, hour type, and cost center and compares the data against the contractual allocation plan. Any exception or deviation identified through this review is routed to the responsible supervisor for resolution before payroll is processed. Supervisors are responsible for correcting and approving timecard errors or documenting confirmation that the timesheet accurately reflects the work performed. This process is designed to ensure that timecards are reviewed, approved, and retained in support of payroll costs charged to federal awards. Management will continue to evaluate this control and implement enhancements as needed as part of its ongoing commitment to continuous quality improvement.
Finding 2025-003 a. Name of Contact Person Responsible for Corrective Action: Jeff Jones, Business Manager b. Corrective Action Planned: Additional Training has been provided during professional development sessions to keep in the forefront the importance of preventing conflicts of interest as well ...
Finding 2025-003 a. Name of Contact Person Responsible for Corrective Action: Jeff Jones, Business Manager b. Corrective Action Planned: Additional Training has been provided during professional development sessions to keep in the forefront the importance of preventing conflicts of interest as well as possible nepotism as defined by Miss. Code Ann. § 25-1-53 and Miss. Code Ann. § 25-4-105(1). New hires are required to disclose possible conflicts of interest during the application process. Department heads making recommendations for hire are required to disclose if they are related to the person they are recommending for hire. c. Anticipated Completion Date: Training was provided in February, 2026, after disclosures were added to the employment applications in the human resource software asking the applicant to disclose if they are aware if they are related to anyone currently working in the district. As soon as the violation was identified, the Office of Child Nutrition at the Mississippi Department of Education was notified
Finding #2025-003: Payroll Error Responsible Individual: Debbie Sullivan, Fiscal Coordinator and Jennifer Brook, Chief Financial Officer Corrective Action Plan: The error resulted from a payroll system calculation issue. Future wage adjustments will be reviewed for potential similar errors. Anticipa...
Finding #2025-003: Payroll Error Responsible Individual: Debbie Sullivan, Fiscal Coordinator and Jennifer Brook, Chief Financial Officer Corrective Action Plan: The error resulted from a payroll system calculation issue. Future wage adjustments will be reviewed for potential similar errors. Anticipated Completion Date: October 31, 2026
2025-071a: EOHHS is actively reassessing the current MMIS system configuration and operational processes. In collaboration with Gainwell, a dedicated project is underway to strengthen controls and implement guardrails designed to prevent this from occurring in the future. Several potential solutions...
2025-071a: EOHHS is actively reassessing the current MMIS system configuration and operational processes. In collaboration with Gainwell, a dedicated project is underway to strengthen controls and implement guardrails designed to prevent this from occurring in the future. Several potential solutions are currently being evaluated and developed, with the goal of enhancing the system, oversight, and compliance. 2025-071b: The State is required to provide ongoing oversight and monitoring of CCBHC’s. EOHHS Program Integrity Unit has implemented an audit plan for all CCBHC’s. This plan includes review of historical records as well as on-site visits. Should any findings or questioned costs be identified, EOHHS will determine the appropriate corrective actions and reimburse the federal grantor, as necessary. 2025-071c: Given all CCBHC’s will be audited, any findings identified during an audit or investigation will be evaluated by EOHHS. If EOHHS concludes that a credible allegation of fraud exists, EOHHS will prepare the case record and submit a referral to MFCU for investigation and any subsequent action deemed appropriate. Anticipated Completion Dates: 2025-071a: January 2027 2025-071b: September 2027 2025-071c: Ongoing Contact Persons: Hector Rivera, Interdepartmental Project Manager, Executive Office of Health and Human Services hector.l.rivera@ohhs.ri.gov Lynn Doherty, Managed Care Compliance Officer, Executive Office of Health & Human Services lynn.doherty@ohhs.ri.gov
EOHHS is in agreement with these findings. EOHHS has successfully addressed the deficiencies noted in these findings with updated requirements for this provider type. Community Health Workers have been elevated to high-risk status by Medicaid under “Medicaid Payments and Providers” 210-RICR-20-00-1,...
EOHHS is in agreement with these findings. EOHHS has successfully addressed the deficiencies noted in these findings with updated requirements for this provider type. Community Health Workers have been elevated to high-risk status by Medicaid under “Medicaid Payments and Providers” 210-RICR-20-00-1, which necessitates a National Criminal Background Check through fingerprinting. All enrolled community health worker providers were disenrolled effective December 1, 2025, and required to apply for enrollment under the new, enhanced requirements in the latest Community Health Worker Provider Manual, including the background check and requirement to enroll as a group with a National Provider Identifier (NPI), and as individual rendering providers with an NPI. All current CHW providers are now enrolled with the enhanced screening requirements. Limitations on reimbursement for services have also been successfully implemented, with system edits in place to deny claims billed in noncompliance with the new requirements outlined in the provider manual. Additionally, EOHHS Office of Program Integrity has audited outlier providers (in terms of utilization metrics), identifying overpayments and also collaborating with the MFCU for law enforcement intervention. EOHHS considers finding 2025-070a to be completed based on previous activities. For finding, 2025-070b, EOHHS is finalizing its last CHW audits while the MFCU completes its investigations based on Program Integrity’s referrals. Anticipated Completion Dates: 2025-070a: Complete 2025-070b: Estimate is August 2026 Contact Person: Nicholas James, Implementation Director of Policy and Programs, Executive Office of Health and Human Services nicholas.james@ohhs.ri.gov
EOHHS will establish an audit cycle to this service that will ensure the billing requirements for all bundled services are clear and that it is also clear that the unbundling of the rates is not allowed and may cause recoups for the services billed. Based on the results of the audit, systemic billin...
EOHHS will establish an audit cycle to this service that will ensure the billing requirements for all bundled services are clear and that it is also clear that the unbundling of the rates is not allowed and may cause recoups for the services billed. Based on the results of the audit, systemic billing error issues will be reviewed with Gainwell and evaluated for edits to correct the issues. EOHHS will also engage with Gainwell and BHDDH to implement enhanced technical assistance to ensure compliance. Anticipated Completion Date: December 31, 2026 Contact Persons: David McMahon, Assistant Director of Financial Contracts, Executive Office of Health and Human Services david.g.mcmahon@ohhs.ri.gov Hector Rivera, Interdepartmental Project Manager, Executive Office of Health and Human Services hector.l.rivera@ohhs.ri.gov
2025-068a: EOHHS will establish a systemwide audit cycle of this service to ensure the providers are appropriately billing. 2025-068b: EOHHS is actively reassessing the current MMIS system configuration and operational processes. In collaboration with Gainwell Technologies, a dedicated project is un...
2025-068a: EOHHS will establish a systemwide audit cycle of this service to ensure the providers are appropriately billing. 2025-068b: EOHHS is actively reassessing the current MMIS system configuration and operational processes. In collaboration with Gainwell Technologies, a dedicated project is underway to strengthen controls and implement guardrails designed to prevent this from occurring in the future. Several potential solutions are currently being evaluated and developed, with the goal of enhancing the system, oversight, and compliance. 2025-068c: EOHHS is actively reassessing the current provider Billing Manual to ensure the billing requirements for all bundled services is clear and that it is also clear that the unbundling of the rates is not allowed and may cause recoups for the services billed. 2025-068d: EOHHS will establish a systemwide audit cycle of this service to ensure the providers are appropriately billing. Anticipated Completion Date: November 30, 2026 Contact Persons: David McMahon, Assistant Director of Financial Contracts, Executive Office of Health and Human Services david.g.mcmahon@ohhs.ri.gov Hector Rivera, Interdepartmental Project Manager, Executive Office of Health and Human Services hector.l.rivera@ohhs.ri.gov
To satisfy this audit finding, EOHHS requested a systems solution to process Eleanor Slater Hospital (ESH) claims which would automate a recipient’s TPL, Medicare, and MCO financial obligations before Medicaid is billed. EOHHS, BHDDH, and Gainwell Technologies have been working on said system modifi...
To satisfy this audit finding, EOHHS requested a systems solution to process Eleanor Slater Hospital (ESH) claims which would automate a recipient’s TPL, Medicare, and MCO financial obligations before Medicaid is billed. EOHHS, BHDDH, and Gainwell Technologies have been working on said system modification project (PJ0630 – Other Insurance Edits for Eleanor Slater Hospital Claims) and the Business Design Document was reviewed with all parties on 6/22/2026. Anticipated Completion Date: SFY 2027 Q1 Contact Person: Hector Rivera, Interdepartmental Project Manager, Executive Office of Health and Human Services hector.l.rivera@ohhs.ri.gov
2025-066a: In order to address repeat income deficiencies from SWICA, Medicaid added The Work Number (TWN) as a new data source in August 2025. Since then, RI Bridges has been modified to first verify earned income against TWN. With this enhancement, Medicaid has seen an improvement in how earned in...
2025-066a: In order to address repeat income deficiencies from SWICA, Medicaid added The Work Number (TWN) as a new data source in August 2025. Since then, RI Bridges has been modified to first verify earned income against TWN. With this enhancement, Medicaid has seen an improvement in how earned income is verified during the post-eligibility verification (PEV) and annual renewal processes. Medicaid has determined the individuals flagged as being enrolled under the expansion pathway beyond their 65th birthday are the result of exceptions to the mass update eligibility process. Medicaid is working with our system vendor to develop a solution that will bypass this exception and terminate expansion eligibility for those turning 65 years old. RI Bridges appropriately identified the individual in question as requiring verification of citizenship status. However, as noted in the expansion age-out response, the mass update eligibility process exceptioned out, leaving the verification as unresolved and requiring manual review. Medicaid is working with our system vendor to develop a solution that will bypass this exception and terminate eligibility. Effective December 2025, the RI Bridges system receives quarterly matches from the SSA Death Master File (DMF). The DMF is automatically sent to the State as part of the quarterly PARIS data matching process. The State has deployed temporary system measures to process the file and automatically terminate Medicaid eligibility for individuals flagged as deceased on the DMF. As per section 71104 of the Working Families Tax Cut (WFTC) legislation, signed by the President on 7/4/25, the State will be deploying a long-term system enhancement to, “at least a quarterly basis, check the DMF to identify if enrolled individuals are deceased. If an individual is identified as deceased on the DMF, then the state must treat this information as factual, disenroll the individual, and discontinue any payments for items or services furnished after the death of the individual.” This enhancement is scheduled for the March 2027 release. In July 2024, federal partners operating the PARIS interstate match informed the State of a hold on PARIS interstate matching files. PARIS lifted the hold in October 2024. In November 2024, the State identified several defects in the PARIS results and suppressed requests for verification. A temporary system enhancement was logged to address the deficiencies and ensure the process was only requesting residency verification from individuals believed to be receiving Medicaid in another State. Long-term enhancements to the PARIS interstate match process are scheduled for late 2027. 2025-066b: Medicaid will continue to work with the Department of Human Services and HealthSource RI to improve reconciliation and quality assurance monitoring of eligibility and operational processes. Including, but not limited to automated quality control checks on batch processes, manual eligibility reviews of quarterly/annual activities, creating specialized reports, improving task logic, and identifying areas of repeat non-compliance to ensure appropriate controls are in place. 2025-066c: Upon notification from the systems team, Medicaid Finance will return any identified ineligible costs to the federal grantor. Anticipated Completion Dates: 2025-066a: Q4 2026 (exception scenarios) and Q4 2027 (PARIS) 2025-066b: Q4 2026 2025-066c: Ongoing Contact Persons: Anthony Salvo, Implementation Director of Policy and Programs, Executive Office of Health and Human Services anthony.salvo@ohhs.ri.gov Dezeree Hodish, Associate Director (Financial Management), Executive Office of Health and Human Services dezeree.hodish@ohhs.ri.gov
Consistent with RIGL 40-8-13.4, the Rhode Island Medicaid State Plan includes the following: Annual review. EOHHS will review the DRG payment method at least annually, making updates as appropriate through the rule-making process. The scope of the annual review will include at least the DRG algorith...
Consistent with RIGL 40-8-13.4, the Rhode Island Medicaid State Plan includes the following: Annual review. EOHHS will review the DRG payment method at least annually, making updates as appropriate through the rule-making process. The scope of the annual review will include at least the DRG algorithm version, the DRG Relative Weights, the DRG Base Price(s), the outlier thresholds, outlier payment parameters, policy adjustors and the age adjustors. With respect to the DRG Base Price, EOHHS will take into consideration at least the following factors in deciding what change, if any, to implement: changes or levels of beneficiary access to quality care; the Center for Medicare and Medicaid Services (CMS) Inpatient Hospital Prospective Payment System Market Basket Update without productivity adjustment for the current federal fiscal year; technical corrections to offset changes in DRG Relative Weights or policy adjustors; changes in how hospitals provide diagnosis and procedure codes on claims; and budget allocations.” EOHHS annually reviews the inpatient hospital rate components in conjunction with annual market basket adjustments for the upcoming fiscal year. For example, this review for SFY 2027 occurred on June 18, 2026. However, in response to this finding, EOHHS will request amendment to the Rhode Island General Laws through the FY 2028 budget process. Then, upon enactment, it will then pursue a state plan amendment (SPA) to more specifically align with current practices. If CMS opposes the amendment, then EOHHS could pursue an update to the DRG model. Doing so would first require procurement of actuarial services to analyze six months of inpatient claims in order to determine new rates. Following the analysis, significant work in the MMIS would be needed to implement the rate and update the DRG grouper. MMIS work is estimated to require about 1,000 project hours. Additionally state funding would be needed to implement this change; as EOHHS does not currently have funding to accommodate this work, it would seek budget authority before moving forward. Anticipated Completion Date: FY 2028 Contact Person:Patricia Arruda, Interdepartmental Project Manager, Executive Office of Health and Human Services patricia.arruda@ohhs.ri.gov
A file exchange process has been implemented where Gainwell pulls a monthly TPL report for each MCO which is shared with EOHHS to share with the MCO’s. EOHHS is unable to force the MCO’s to use the shared TPL data, we can only suggest they use it. At this point in time, the accuracy of the State’s T...
A file exchange process has been implemented where Gainwell pulls a monthly TPL report for each MCO which is shared with EOHHS to share with the MCO’s. EOHHS is unable to force the MCO’s to use the shared TPL data, we can only suggest they use it. At this point in time, the accuracy of the State’s TPL data is not good enough to reject encounter claims from the MCO’s. EOHHS continues to work on improving the TPL process specifically cleaning up the TPL data in the MMIS and eligibility system today. Future system enhancements include a direct TPL vendor and new TPL module which should improve TPL accuracy. Anticipated Completion Date: July 31, 2028 Contact Person: Jeffrey Schmeltz, Chief, Family Health Systems, Executive Office of Health and Human Services jeffrey.schmeltz@ohhs.ri.gov
2025-062a: EOHHS recently determined that the MCOs were unknowingly assigning the incorrect Organization Type Code to multiple provider types since EOHHS adopted the 837 standard in SFY 2014. This created unacceptably high encounter denial rates that led EOHHS to relax certain edits in the years tha...
2025-062a: EOHHS recently determined that the MCOs were unknowingly assigning the incorrect Organization Type Code to multiple provider types since EOHHS adopted the 837 standard in SFY 2014. This created unacceptably high encounter denial rates that led EOHHS to relax certain edits in the years that followed. An MMIS project is currently underway that will help ensure the plans are assigning the correct codes to their providers. Once the MCO's are submitting the correct codes, EOHHS will be able to begin the process of re-enabling the edits in the 2nd half of SFY 2027, which will improve controls over encounter claims data submissions. 2025-062b: Medicaid has deployed several control measures to improve the identification and processing of individuals determined to be deceased and living out State. In January 2026, the State operationalized a new interface with the National Change of Address (NCOA) database. The RI Bridges system verifies addresses of Medicaid recipients on a weekly (those with returned mail) and monthly (entire Medicaid population) basis. Automated rules ensure individuals with an out of State address received from NCOA are provided an opportunity to verify their residency. Failure to respond to the verification results in termination of eligibility. Effective December 2025, the RI Bridges system receives quarterly matches from the SSA Death Master File (DMF). The DMF is automatically sent to the State as part of the quarterly PARIS data matching process. The State has deployed temporary system measures to process the file and automatically terminate Medicaid eligibility for individuals flagged as deceased on the DMF. As per section 71104 of the Working Families Tax Cut (WFTC) legislation, signed by the President on 7/4/25, the State will be deploying a long-term system enhancement to, “at least a quarterly basis, check the DMF to identify if enrolled individuals are deceased. If an individual is identified as deceased on the DMF, then the state must treat this information as factual, disenroll the individual, and discontinue any payments for items or services furnished after the death of the individual.” This enhancement is scheduled for the March 2027 release. Anticipated Completion Dates: 2025-062a: Q4 SFY 2027 2025-062b: March 2027 Contact Persons: Rob Tingle, Chief of Program Analytics, Executive Office of Health and Human Services robert.tingle@ohhs.ri.gov Anthony Salvo, Implementation Director of Policy and Programs, Executive Office of Health and Human Services anthony.salvo@ohhs.ri.gov
EOHHS understands that the audit findings primarily resulted from three items: 1. Lack of management oversight of the AlloCAP system’s functionality and its effect on financial reporting. 2. The use of incorrect FMAPs on sister agencies’ quarterly administrative claiming reports submitted to Medicai...
EOHHS understands that the audit findings primarily resulted from three items: 1. Lack of management oversight of the AlloCAP system’s functionality and its effect on financial reporting. 2. The use of incorrect FMAPs on sister agencies’ quarterly administrative claiming reports submitted to Medicaid Finance, and Medicaid’s subsequent lack of review of these reports. 3. No segregation of duties in the Assistant Director Financial and Contract Management position within the EOHHS Central Management finance team. Several actions have been taken to enhance oversight of the AlloCAP system functionality and improve the overall cost allocation process, including hiring an Administrator, Financial Management position. This position has been cross trained and is completing the quarterly AlloCAP activities with review completed by the Assistant Director Financial and Contract Management position. Management’s additional correction action plans for each of these are below. 1. Finance will request a SOC I Type II report from its AlloCAP vendor. The report(s) will be shared with CFOs at all agencies using the AlloCAP system for Medicaid allocations for their review. 2. Finance has already implemented controls to rectify this finding. The items below were implemented during SFY 2026. a. Additional training for sister agencies on the administrative claiming reporting process. Trainings were held on February 4th and April 15th, 2026, and included the importance of the correct FMAP and a list of FMAPs by CMS-64 line item. b. Office hours with Medicaid administrative claiming agencies prior to the submission of quarterly expenditure reports. This allows agencies to ask questions and troubleshoot possible issues prior to report submission. c. Medicaid Finance review of all agency-submitted quarterly expenditure reports. This includes checking that: i. the reported federal amounts tie to the quarterly draw down amount. If there is a variance, the variance must be explained and documented for future reconciliation; ii. FMAPs are used and align with CMS-64 line item FMAPs; iii. The reported federal amounts do not exceed CMS-64 line item budgets (when applicable). d. Training additional Medicaid Finance staff on the review of agency submitted reports and data entry to separate staff duties and allow for double-checking of staff work. Finance will continue to refine improvements and implement processes to ensure reporting accuracy, including drafting relevant SOPs. Additionally, Medicaid Finance retained a contractor that has worked with other states to review the CMS-64 claiming process to suggest further areas of improvement and automation. 3. EOHHS will continue to explore options for improving controls over AlloCAP system functionality and cost allocation work. 4. Finance staff across EOHHS and Medicaid teams will detail additional controls and recommendations for implementation. Anticipated Completion Date: September 1, 2026 Contact Persons: Dezeree Hodish, Associate Director, Financial Management, Executive Office of Health and Human Services dezeree.hodish@ohhs.ri.gov Victoria Pavao, Assistant Director, Financial and Contract Management, Executive Office of Health and Human Services victoria.pavao@ohhs.ri.gov
EOHHS understands that this finding stems from two items. 1. Current limitations of the MMIS and the volume of manual transactions, including retroactive capitation adjustments and corrective journal entries related to CHIP funding 2. Lack of internal controls regarding CHIP draw downs and reporting...
EOHHS understands that this finding stems from two items. 1. Current limitations of the MMIS and the volume of manual transactions, including retroactive capitation adjustments and corrective journal entries related to CHIP funding 2. Lack of internal controls regarding CHIP draw downs and reporting. Management’s correction action plans for each item are below. 1. EOHHS will improve SOPs to include additional review of source data, collation of source data, and review of formula calculations for manual adjustment activities. These steps will be built into analyst training, and measures have been taken to include training and the creation/improvements of internal SOPs before the upcoming SFY 2026 closing activities occur. EOHHS will include within its forthcoming procurement of specific MMIS modules requirements to reduce the number of manual calculations and related entries. 2. Medicaid finance has and will take the following actions. a. Staff training. i. In May 2026, Medicaid Finance sent two employees to internal control training, which was sponsored by the Office of the Auditor General (OAG) ii. In July 2027, these two employees will train all Medicaid finance staff members on the importance of risk and internal controls using material from the OAG sponsored training. b. SOP tracker and dedicated work time i. Medicaid finance created an inventory of all finance-related SOPs to track assignments to ensure timely completion of high priority SOPs. ii. The Associate Director (Financial Management) has weekly worktime dedicated to the completion of high priority SOPs. iii. Each fiscal close, one staff member has been assigned to work with analysts to draft six SOPs (two from each finance unit—fee for service, managed care, and federal reporting) to continue to document all year end closing procedures. c. Post FFY-quarter end reconciliations i. Beginning in FFY 2026, the Associate Director (Financial Management) completes a post-quarter reconciliation of Medicaid draw down accounts (benefits, administrative claiming, and CHIP). ii. Staff email the Associate Director (Financial Management) after each federal draw down and include verification of the PMS draw down amount and account. iii. The Associate Director (Financial Management) enters this into a tracking sheet to ensure sufficient federal funds remain in each account during the quarter. Should additional funds be needed, Medicaid finance submits a supplemental budget request to CMS to prevent the shifting of funds between federal accounts benefits, administrative claiming, and CHIP accounts. iv. Shortly after the end of each FFY year quarter close, the Associate Director (Financial Management) completes the following: 1. Receives staff-run reports form the PMS system showing all draw downs in the previous quarter. 2. Checks that Medicaid Finance internal trackers (high level and detail trackers) accurately capture correct federal accounts and amounts. If variances, research is completed to reconcile to PMS. v. Associate Director (Financial Management) ensures that all CMS adjustments, such as Parts A, B, and D adjustments and TPL/AOR adjustments are included in the high-level fund tracker to match and verify CMS’ quarterly account balances. d. EOHHS acknowledges that many of the new checks and reviews implemented have not been formally codified. It will work to codify controls to document these reviews and checks. Anticipated Completion Date: Additional SOP and internal control development is ongoing and the date of procurement/implementation of the MMIS Finance module is still be determined. Contact Persons: Storm Lawrence, Chief of Strategic Planning, Monitoring & Evaluation, Executive Office of Health and Human Services storm.lawrence@ohhs.ri.gov Dezeree Hodish, Associate Director (Financial Management), Executive Office of Health and Human Services dezeree.hodish@ohhs.ri.gov
Management concurs with the findings related to controls over child care eligibility determinations and provider payments. Management notes that the number and scope of findings identified in the current audit have been substantially reduced compared to prior Single Audits, reflecting continued prog...
Management concurs with the findings related to controls over child care eligibility determinations and provider payments. Management notes that the number and scope of findings identified in the current audit have been substantially reduced compared to prior Single Audits, reflecting continued progress in strengthening internal controls. The Office of Child Care remains committed to enhancing eligibility determination processes and related internal controls, including ensuring that required eligibility documentation is consistently maintained in the electronic case record. Corrective actions to address the remaining findings, along with the anticipated completion dates, are outlined below. [See Corrective Action Plans for table.] In addition to the corrective actions outlined above, the Department is strengthening supervisory oversight through implementation of routine pre-authorization quality reviews and standardized supervisory monitoring practices. Supervisors will utilize these tools as part of ongoing quality assurance activities to verify that required eligibility documentation is complete prior to authorization, identify recurring error trends, and provide targeted coaching, training, and process improvements to strengthen program integrity and reduce future eligibility errors. Management agrees with the recommendation to evaluate modifications to the existing eligibility system to support eligibility determinations under the CCAP Child Care Staff program. The Department previously assessed the feasibility of modifying RIBridges to accommodate eligibility determinations for the CCAP Child Care Educators and Child Care Staff pilot program. At that time, implementation was not feasible due to competing system development priorities, limited vendor development capacity, and the pilot status of the program. Since the period covered by the audit, the Department has implemented a requirement that participants in the pilot program also apply for the traditional CCAP program. This change has strengthened documentation requirements and helped mitigate risks associated with incomplete eligibility documentation. While these interim measures have improved program administration, the Department recognizes that administering eligibility determinations outside of the primary eligibility system is not a sustainable long-term approach. Accordingly, the Department is reassessing the future administration of the pilot program and evaluating options to incorporate eligibility determinations into RIBridges or, alternatively, to develop the functionality within RISES and integrate it with RIBridges. The Department will determine the most appropriate path forward based on program needs, system capabilities, and available resources to ensure a sustainable and well-controlled eligibility process. Additionally, the Department has strengthened controls over provider payments for the CCAP Child Care Staff pilot program since the audit period. Prior to each payment, the CCAP program team reviews the copayment workbook to identify and resolve discrepancies between pilot program payments and traditional CCAP benefits. In addition, the CCAP Finance team performs a formal review of each payment workbook before payments are processed. The vendor supporting the pilot has also enhanced its payment file process by implementing an additional level of financial review by the project team prior to submission and incorporating safeguards to identify attendance records that may have been previously paid, reducing the risk of duplicate payments. The Department has established procedures to recover identified overpayments, including both one-time recoveries through withholding from future pilot payments, where appropriate, and a formal recoupment process for providers who are no longer participating in the pilot program. These enhanced controls are intended to strengthen payment accuracy and support effective stewardship of program funds. Anticipated Completion Dates: See table above Contact Person: Nicole Chiello, Associate Director, Office of Child Care, Department of Human Services nicole.chiello@dhs.ri.gov
RIDOH agrees with this repeat finding and recommendations. RIDOH staff often do not pay attention to the Budgeted Allocation column on their time sheets, focusing only on their reporting of time and effort, which leads to inaccurate cumulative Budgeted Allocations on Variance Reports leading to inac...
RIDOH agrees with this repeat finding and recommendations. RIDOH staff often do not pay attention to the Budgeted Allocation column on their time sheets, focusing only on their reporting of time and effort, which leads to inaccurate cumulative Budgeted Allocations on Variance Reports leading to inaccurate variances for correction. The RIDOH reconciliation methodology includes a step to compare reported time and effort to financial system payroll reports (the Variance Correction tab in each reconciliation adjustment calculation spreadsheet). This ensures that all adjustments are accurately processed to the appropriate grants even if they do not appear to agree with the variances in individual Variance Reports. 2025-043a: RIDOH abolished all “umbrella” or general Programs/Activities from Time Sheet Workbooks as of SFY2027 Qtr1. All grant activities now are reported with Appropriation numbers, and grouped activities were removed, except for Medicaid Match account pairs and consecutive federal awards for the same purpose which are spent down in sequence (e.g., DWQ State Revolving Fund awards). RIDOH continues to monitor the status of reporting by Project Tags in Workday, which will provide automatic reconciliation per time and effort reported. Currently, reporting by Project Tags results in inaccurate charging of leave time. When that issue has been resolved, RIDOH will switch to Workday Project Tag reporting and will discontinue using Time Sheet Workbooks. 2025-043b: RIDOH will review SFY2026 Time Sheet Workbooks and revise them to show the correct budgeted allocations, providing the basis for the variance adjustments. Any revisions will be documented. Time and effort reported will not be changed. For SFY2027, RIDOH Grants Management began providing payroll reports formatted by the Time Sheet Workbook Programs/Activities for Division Finance Liaisons to update and share with Division staff, to support correct recording of Budgeted Allocations in Time Sheet Workbooks. RIDOH Grants Management will continue to do this quarterly, ensuring accurate variance calculations on quarterly Variance Reports. 2025-043c: RIDOH will review the SFY2025 payroll reconciliations in question and make corrections as needed. Anticipated Completion Dates: 2025-043a: Enhanced reporting completed. Transition to Workday Project Tag reporting by June 30, 2027 2025-043b: Ongoing 2025-043c: December 31, 2026 Contact Persons: Carla Lundquist, Deputy CFO / Federal Grants Manager, Department of Health carla.lundquist@health.ri.gov Shannon Healy, Assistant Federal Grants Manager, Department of Health shannon.healy@health.ri.gov
We agree with the recommendations. We have resubmitted the FY24 SWCAP to include these costs. We will work with our SWCAP consulting partner to review prior submissions to ensure grant management services are assessed as billed costs and include the costs going forward. Anticipated Completion Date: ...
We agree with the recommendations. We have resubmitted the FY24 SWCAP to include these costs. We will work with our SWCAP consulting partner to review prior submissions to ensure grant management services are assessed as billed costs and include the costs going forward. Anticipated Completion Date: To Be Determined Contact Person: Steve Thompson, Associate Controller, Office of Accounts & Control, Department of Administration steve.thompson@doa.ri.gov
2 3 416 »