Finding 2024-220: The expenditures reported on the Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program form (CMS-64) were understated by $16,348,275 for the Medicaid program. Agency’s View: Agree Corrective Action: As noted in the finding, the late submission and understa...
Finding 2024-220: The expenditures reported on the Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program form (CMS-64) were understated by $16,348,275 for the Medicaid program. Agency’s View: Agree Corrective Action: As noted in the finding, the late submission and understated expenditures were primarily the result of the Luma system implementation and the unavailability of required data for CMS reporting. During the development phase, concerns were raised regarding the system’s ability to meet federal reporting requirements—specifically the CMS-64 and CMS-21 reports for Medicaid. The Budget Team requested sample output reports to proactively update workpapers and ensure accurate and timely reporting; however, these requests were not fulfilled. During the delay in timely reporting, DHW maintained ongoing communication with our federal partners. The Budget Team developed the necessary reports and revised internal processes to bring reporting current. The Budget Team also worked closely with our federal auditors to ensure no reporting elements were inadvertently omitted. During this review, we identified that our initial submission excluded indirect expenditures associated with the federally approved Cost Allocation Plan. This allocation process cannot be completed within Luma and requires coordination among the State Controller’s Office, two external vendors, and the Cost Allocation Budget Analyst. These dependencies created significant delays. As a result, indirect cost allocation charges were substantially delayed, and the first successful import for July 2023 did not occur until November 2023. Upon receiving the complete data, the Reporting Team corrected the process, documented the updates, and submitted a prior period adjustment to capture previously under-reported expenditures. As we entered SFY 2025, we had a more comprehensive understanding of the new processes and required timelines. This resulted in improved timeliness: the December 2024 submission was five days late submitted 2/4/25, the March 2025 submission was two days late submitted 4/30/25 and resubmitted 7/31/25, and the June 2025 submission was only one day late submitted 7/31/25. We are pleased to report that the September 2025 submission was certified on time and submitted 10/30/25. While some reporting adjustments were needed, CMS and the Budget Team collaborated effectively to update and recertify the report to ensure accuracy. We have updated all relevant process documentation and continue to automate steps where feasible to further improve efficiency and reduce turnaround times. Anticipated Corrective Action Date: Completed 10/30/2025 Responsible for Corrective Action: Magnum Forkner, Financial Manager magnum.forkner@dhw.idaho.gov 208-332-7241