Corrective Action Plans

Finding 1155735 (2023-001)

Material Weakness 2023

Baycare Health System, Inc. and Affiliates

FL

Reporting Questioned Costs § 200.303

The grant accounting and SEFA preparation process will be refined, improved and documented. Internal resources will be reallocated to ensure sufficient coverage of these processes, and the primary accountability and oversight will shift to System Accounting. Management will ensure that in preparatio...

The grant accounting and SEFA preparation process will be refined, improved and documented. Internal resources will be reallocated to ensure sufficient coverage of these processes, and the primary accountability and oversight will shift to System Accounting. Management will ensure that in preparation of the SEFA, (1) a team member will assemble the initial reconciliation, (2) management will review the initial reconciliation and review the consolidation from all BayCare entities to the combined SEFA, (3) A final review will be conducted by the Director of Accounting. Sign-off from each preparer/reviewer shall be required. Meetings will be conducted as needed with departments outside of Hospital Finance to ensure completeness and accuracy of data. Start September 2025, Finalized Q1 2026

View Audit 368033

Finding 1155633 (2023-003)

Material Weakness 2023

Philadelphia Area Labor Management Committee

PA

Questioned Costs Procurement, Suspension & Debarment Allowable Costs / Cost Principles § 200.302

2023-3 Allowable costs-credit cards – Assistance Listing Number 11.307 Recommendation: We recommend that management implement a more robust internal control system to ensure all federal expenditures are supported by proper documentation. Explanation of disagreement with audit finding: We believe the...

2023-3 Allowable costs-credit cards – Assistance Listing Number 11.307 Recommendation: We recommend that management implement a more robust internal control system to ensure all federal expenditures are supported by proper documentation. Explanation of disagreement with audit finding: We believe the costs referred to were indeed for allowable expenses under the federal program. We will however start to maintain all original source documentation. Action taken in response to finding: Management has required all original source documentation be maintained regardless of dollar amount. Name of contact person responsible for corrective action: Anthony Wigglesworth, Executive Director Corrective action plan has been implemented in 2025.

View Audit 367886 Questioned Costs: $1

Finding 1155632 (2023-002)

Material Weakness 2023

Philadelphia Area Labor Management Committee

PA

Allowable Costs / Cost Principles Questioned Costs § 200.430

U.S. Department of Commerce, Philadelphia Works, Inc. 2023-2 Direct Labor Costs – Assistance Listing Number 11.307 Recommendation: We recommend that the PALM utilize a time management software which integrates with their payroll processing, to easily identify direct labor costs related to the federa...

U.S. Department of Commerce, Philadelphia Works, Inc. 2023-2 Direct Labor Costs – Assistance Listing Number 11.307 Recommendation: We recommend that the PALM utilize a time management software which integrates with their payroll processing, to easily identify direct labor costs related to the federal program. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Management has implemented a new time management software in 2025 to track and manage direct labor costs relating to the administration of federal programs.

View Audit 367886 Questioned Costs: $1

Finding 1155631 (2023-001)

Material Weakness 2023

Philadelphia Area Labor Management Committee

PA

Questioned Costs Reporting Internal Control / Segregation of Duties § 200.512

U.S. Department of Commerce, Philadelphia Works, Inc. 2023-1 Timely submission of Data Collection Form – Assistance Listing Number 11.307 Recommendation: We recommend PALM engage a certified public accountant to conduct a Single Audit as long as the PALM meets the Single Audit criteria Explanation o...

U.S. Department of Commerce, Philadelphia Works, Inc. 2023-1 Timely submission of Data Collection Form – Assistance Listing Number 11.307 Recommendation: We recommend PALM engage a certified public accountant to conduct a Single Audit as long as the PALM meets the Single Audit criteria Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Management has engaged a certified public accountant to complete a Single Audit and assist in the submission of the data collection form. Name of contact person responsible for corrective action: Anthony Wigglesworth, Executive Director. Corrective action plan has been implemented prior to the due date of the December 31, 2024 data collection form.

View Audit 367886

Finding 1155459 (2023-003)

Material Weakness 2023

Claremont Learning Partnership

NH

Questioned Costs Procurement, Suspension & Debarment Subrecipient Monitoring § 200.303 § 200.313 § 200.317 § 200.431

Finding 2023-003: Establish and maintain effective internal control over the Federal award Plan: We have ensured all policies and procedures have been vetted by an attorney and approved by the River View Board of Trustees and the Claremont Learning Partnership Board of Directors. Moving forward, the...

Finding 2023-003: Establish and maintain effective internal control over the Federal award Plan: We have ensured all policies and procedures have been vetted by an attorney and approved by the River View Board of Trustees and the Claremont Learning Partnership Board of Directors. Moving forward, the Executive Director will ensure that all policies and procedures stay current and are reviewed by the Board annually. FY-22 & FY-23 Audits were completed in tandem, all corrections were made as soon as the issue was identified. Expected Implementation Date: RiverView amended the policy on June 17, 2025, CLP amended the policy on July 3, 2025. Contact: Cathy Pellerin Executive Director, Claremont Learning Partnership 169 Main Street; Claremont, NH 03743 603-287-7120

View Audit 367741

Finding 1155441 (2023-001)

Material Weakness 2023

Promedica Health System and Subsidiaries

OH

Reporting Questioned Costs Material Weakness § 200.502 § 200.508 § 200.510

Condition: Controls in place were not adequate to ensure the schedule of federal expenditures was complete and accurate. Planned Corrective Action: Management fully understands the importance of internal controls to ensure the schedule of federal expenditures is complete and accurate. The Grants Dep...

Condition: Controls in place were not adequate to ensure the schedule of federal expenditures was complete and accurate. Planned Corrective Action: Management fully understands the importance of internal controls to ensure the schedule of federal expenditures is complete and accurate. The Grants Department will amend its current written processes regarding award establishment to include requiring documentation indicating an award is federal funds prior to establishing the project in Infor CloudSuite Financials & Supply Management (Accounting software). Additionally, the Grants Department will routinely audit the database the department utilizes to record awards to ensure the field to note federal awards is properly updated. Furthermore, the SEFA will be reviewed with documented sign-off by each member of the Grants Team prior to submission. Contact person responsible for corrective action: Stephanie Cihon Anticipated Completion Date: October 31, 2025

View Audit 367737

Finding 1155440 (2023-002)

Material Weakness 2023

Promedica Health System and Subsidiaries

OH

Questioned Costs Procurement, Suspension & Debarment Significant Deficiency § 200.318 § 200.319 § 200.320

Condition: Controls in place were not adequate to ensure the policy included appropriate procurement thresholds and methods. Planned Corrective Action: Management understands the importance of adhering to procurement thresholds and methods. Procurement policies and grant policies will be updated to ...

Condition: Controls in place were not adequate to ensure the policy included appropriate procurement thresholds and methods. Planned Corrective Action: Management understands the importance of adhering to procurement thresholds and methods. Procurement policies and grant policies will be updated to include federal thresholds and methods to reflect federal Uniform Guidance. Contact person responsible for corrective action: Stephanie Cihon and Andy Vollmar Anticipated Completion Date: October 31,2025

View Audit 367737

Finding 1155309 (2023-015)

Material Weakness 2023

The City of Frederick, Maryland

MD

Questioned Costs Subrecipient Monitoring Eligibility

All expenditures will be verified prior to disbursement to ensure they are paid within the defined grant period.

View Audit 367551 Questioned Costs: $1

Finding 1155294 (2023-007)

Material Weakness 2023

West Side Community Health Services INC

MN

Questioned Costs Reporting Significant Deficiency § 200.303

2023-007 Health Centers Cluster – Assistance Listing No. 93.2242/93.527 Recommendation: We recommend in the future the Organization retain documentation of key control processes occurring for a reasonable retention period to be able to support control activities around grant compliance and financial...

2023-007 Health Centers Cluster – Assistance Listing No. 93.2242/93.527 Recommendation: We recommend in the future the Organization retain documentation of key control processes occurring for a reasonable retention period to be able to support control activities around grant compliance and financial reporting. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Management will retain timesheet documentation moving forward to support control process in place. Name(s) of the contact person(s) responsible for corrective action: Bobby Royal Planned completion date for corrective action plan: December 2025

View Audit 367533

Finding 1155293 (2023-006)

Material Weakness 2023

West Side Community Health Services INC

MN

Internal Control / Segregation of Duties Questioned Costs Significant Deficiency

2023-006 Health Centers Cluster – Assistance Listing No. 93.2242/93.527 Recommendation: We recommend the organization have a review process over determinations to ensure accuracy and provide training as needed to mitigate risk of future errors. We also recommend reviewing procedures in place for ret...

2023-006 Health Centers Cluster – Assistance Listing No. 93.2242/93.527 Recommendation: We recommend the organization have a review process over determinations to ensure accuracy and provide training as needed to mitigate risk of future errors. We also recommend reviewing procedures in place for retaining documentation for sliding fee applications to ensure sufficient detail is retained according to policy. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Management will review sliding fee policies and procedures in place to improve oversight and provide training to the team members conducting the patient intake and reviewing sliding fee applications. Name(s) of the contact person(s) responsible for corrective action: Bobby Royal Planned completion date for corrective action plan: December 2025

View Audit 367533

Finding 1155185 (2023-006)

Material Weakness 2023

Recovery Connections of Central Florida, Inc.

FL

Questioned Costs Allowable Costs / Cost Principles Subrecipient Monitoring

Allowable Costs Recommendation: Recommended Recovery Connections of Central Florida, Inc. maintain documentation of disbursement approval and approval of services provided. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action planned/taken in respon...

Allowable Costs Recommendation: Recommended Recovery Connections of Central Florida, Inc. maintain documentation of disbursement approval and approval of services provided. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action planned/taken in response to finding: We will implement a more structured process for documenting the approval of disbursements. This includes ensuring that disbursements are formally approved by the appropriate authority within the organization. We will also maintain a written record of the approval, including the name of the individual who authorized the disbursement and the date of approval. Name of the contact person responsible for corrective action: Joseph Dodi Planned completion date for corrective action plan: December 31, 2025

View Audit 367424 Questioned Costs: $1

Finding 1155184 (2023-003)

Material Weakness 2023

Recovery Connections of Central Florida, Inc.

FL

Questioned Costs Allowable Costs / Cost Principles Subrecipient Monitoring

Allowable Costs, Period of Performance, and Cash Management Recommendation: Recommended Recovery Connections of Central Florida, Inc. maintain a copy of all contracts, documentation of disbursement approval and supporting documentation of costs included within requests for payment. Explanation of di...

Allowable Costs, Period of Performance, and Cash Management Recommendation: Recommended Recovery Connections of Central Florida, Inc. maintain a copy of all contracts, documentation of disbursement approval and supporting documentation of costs included within requests for payment. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action planned/taken in response to finding: We will implement a more structured process for documenting the approval of disbursements. This includes ensuring that all underlying contracts are maintained and disbursements are formally approved by the appropriate authority within the organization. We will also maintain a written record of the approval, including the name of the individual who authorized the disbursement and the date of approval. Name of the contact person responsible for corrective action: Joseph Dodi Planned completion date for corrective action plan: December 31, 2025

View Audit 367424 Questioned Costs: $1

Finding 1155183 (2023-005)

Material Weakness 2023

Recovery Connections of Central Florida, Inc.

FL

Questioned Costs Subrecipient Monitoring Material Weakness

Reporting Recommendation: Recommended Recovery Connections of Central Florida, Inc. submit its financial and performance reporting as noted in the agreements and maintain documentation of the approval and submission. Explanation of disagreement with audit finding: There is no disagreement with the a...

Reporting Recommendation: Recommended Recovery Connections of Central Florida, Inc. submit its financial and performance reporting as noted in the agreements and maintain documentation of the approval and submission. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action planned/taken in response to finding: We will review each agreement to confirm the reporting requirements, deadlines, and any specific formats or templates that must be followed. A designated team member will be responsible for preparing, reviewing, and submitting the required reports. We will track submission deadlines and ensure that reports are submitted on time. Name of the contact person responsible for corrective action: Joseph Dodi Planned completion date for corrective action plan: December 31, 2025

View Audit 367424

Finding 1155060 (2023-009)

Material Weakness 2023

Muskogee County

OK

Questioned Costs Subrecipient Monitoring

The Board of County Commissioners, with the cooperation and participation of all elected officials, reviews, develops and implements policies and procedures to create a strong internal control environment. The Board of County Commissioners will work with all elected officials, the new county grant a...

The Board of County Commissioners, with the cooperation and participation of all elected officials, reviews, develops and implements policies and procedures to create a strong internal control environment. The Board of County Commissioners will work with all elected officials, the new county grant administrator, and federal, state and local partners to develop policies, procedures, and internal controls designed to accurately track grants, including the application process, verification, oversight, and reporting of grant requirements. The Board of County Commissioners will work with the new county grant administrator to ensure proper grant administration.

View Audit 367368 Questioned Costs: $1

Finding 1155059 (2023-008)

Material Weakness 2023

Muskogee County

OK

Questioned Costs Allowable Costs / Cost Principles Matching / Level of Effort / Earmarking

The Board of County Commissioners will work with all elected officials, the new county grant administrator, and federal, state and local partners to develop policies, procedures, and internal controls designed to accurately track grants, including the application process, verification, oversight, an...

The Board of County Commissioners will work with all elected officials, the new county grant administrator, and federal, state and local partners to develop policies, procedures, and internal controls designed to accurately track grants, including the application process, verification, oversight, and reporting of grant requirements. The Board of County Commissioners will work with the new county grant administrator to ensure proper grant administration.

View Audit 367368 Questioned Costs: $1

Finding 1155057 (2023-006)

Material Weakness 2023

Muskogee County

OK

Questioned Costs Procurement, Suspension & Debarment

The Board of County Commissioners, with the cooperation and participation of all elected officials, reviews, develops and implements policies and procedures to create a strong internal control environment. The Board of County Commissioners will work with all elected officials, the new county grant a...

The Board of County Commissioners, with the cooperation and participation of all elected officials, reviews, develops and implements policies and procedures to create a strong internal control environment. The Board of County Commissioners will work with all elected officials, the new county grant administrator, and federal, state and local partners to develop policies, procedures, and internal controls designed to accurately track grants, including the application process, verification, oversight, and reporting of grant requirements. The Board of County Commissioners will work with the new county grant administrator to ensure proper grant administration.

View Audit 367368 Questioned Costs: $1

Finding 1155054 (2023-004)

Material Weakness 2023

County of Columbia, Pennsylvania

PA

Questioned Costs Student Financial Aid Subrecipient Monitoring

2023-004 - (Noncompliance) Completion of Single Audit Federal Program: Assistance Listing #14.228 Community Development Block Grants/State’s Program and Non-Entitlement Grants in Hawaii, U.S. Department of Housing and Urban Development, Passed Through Pennsylvania Department of Community and Economi...

2023-004 - (Noncompliance) Completion of Single Audit Federal Program: Assistance Listing #14.228 Community Development Block Grants/State’s Program and Non-Entitlement Grants in Hawaii, U.S. Department of Housing and Urban Development, Passed Through Pennsylvania Department of Community and Economic Development and Pennsylvania Emergency Management Agency, Pass-Through Entity Identifying Numbers: C000073444, C000075689, C000082264, C000086078, and PEMA-2022-007 Assistance Listing #21.027, COVID-19 - Coronavirus State and Local Fiscal Recovery Funds, U.S. Department of Treasury, Passed Through Pennsylvania Department of Community and Economic Development, Pass-Through Entity Identifying Number: not available Assistance Listing #21.023, COVID-19 Emergency Rental Assistance Program, U.S. Department of Treasury, Passed Through Pennsylvania Department of Human Services, Pass-Through Entity Identifying Number: not available Assistance Listing #93.658, Foster Care - Title IV-E, U.S. Department of Treasury, Passed Through Pennsylvania Department of Human Services, Pass-Through Entity Identifying Number: not available Condition/Context: The County’s December 31, 2022 Single Audit was not completed and submitted within the required time period. Recommendation: We recommend that as the County gets up and running on the new accounting system, the audit be prioritized in future periods. Views of Responsible Officials and Planned Corrective Actions: The County is working with its fee accountant and external auditors to ensure a timely filing of the Single Audit going forward. Individual Responsible: Finance Department Timeline for corrective action: By December 31, 2026

View Audit 367366

Finding 1155052 (2023-006)

Material Weakness 2023

County of Columbia, Pennsylvania

PA

Questioned Costs Subrecipient Monitoring Allowable Costs / Cost Principles

2024-006 - Reporting - Significant Deficiency/Noncompliance Federal Program: Assistance Listing #21.027, COVID-19 - Coronavirus State and Local Fiscal Recovery Funds, U.S. Department of Treasury, Passed Through Pennsylvania Department of Community and Economic Development, Pass-Through Entity Identi...

2024-006 - Reporting - Significant Deficiency/Noncompliance Federal Program: Assistance Listing #21.027, COVID-19 - Coronavirus State and Local Fiscal Recovery Funds, U.S. Department of Treasury, Passed Through Pennsylvania Department of Community and Economic Development, Pass-Through Entity Identifying Number: not available Condition/Context: The County’s required reports for the quarters ended June 30, 2023, September 30, 2023, and December 31, 2023, were due to be filed by the end of the month after the report end date (July 31, 2023, October 31, 2023, and January 31, 2024, respectively). The County filed its report on August 23, 2023, November 17, 2023, and February 15, 2024 (23, 17, and 15 days, respectively), after the required due date. Views of Responsible Officials and Planned Corrective Actions: Management understands and will seek to implement procedures to ensure future reports are submitted timely. Individual Responsible: Finance Department Timeline for corrective action: By December 31, 2024

View Audit 367366

Finding 1154956 (2023-005)

Material Weakness 2023

Copa Health, Inc.

AZ

Questioned Costs Internal Control / Segregation of Duties § 200.303

Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the Organization is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Con...

Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the Organization is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: The Organization's special reports submitted to the Department of Health and Human Services were not reviewed and approved by a separate individual outside of the preparer. Context: Key line items were tested on the Period 4 special reports submitted to the Department of Health and Human Services. 2 reports were tested, which both lacked appropriate approval. Response: Copa Health, Inc will continue to monitor and review internal control systems and implement new policies and/or procedures when necessary or applicable

View Audit 367290

Finding 1154795 (2023-200)

Material Weakness 2023

Oklahoma Water Resources Board

OK

Special Tests & Provisions Questioned Costs

Finding Number 2023-200 Subject Heading (Financial) or AL no. and program name (Federal) 96.001: Social Security - Disability Insurance Program Planned Corrective Action The OkDRS’s Disability Determination Services (DDS) recognizes that some documentation of licensure verification was not completed...

Finding Number 2023-200 Subject Heading (Financial) or AL no. and program name (Federal) 96.001: Social Security - Disability Insurance Program Planned Corrective Action The OkDRS’s Disability Determination Services (DDS) recognizes that some documentation of licensure verification was not completed. While the actual verification was completed, completing a document that verifies this was not. This was an oversight and is being corrected. There are two areas that are affected, the first being the Professional Relations Office (PRO) who works with outside vendors who complete exams for OkDRS’ s claimants, and the internal Medical Consultants who are directly employed with OkDRS to do internal consulting while the staff makes medical decisions for the claimants. The PRO’s are working to fill in the gaps of the spreadsheet to ensure that the master listing has notations that are missing. The internal reviews were completed and documented in an SSA SharePoint site; however, OkDRS had no required internal process or procedure to notate these verifications. An official process and procedure is being developed and implemented. Please note, in the upcoming year, the DDS case processing system will be implementing required inputs regarding medical consultant licensing. This will provide an additional check point for OkDRS’s documentation and review of medical consultant licenses. Anticipated Completion Date 6/6/2025 Responsible Contact Person Jennifer L. Thornton

View Audit 367158

Finding 1154790 (2023-037)

Material Weakness 2023

Oklahoma Water Resources Board

OK

Allowable Costs / Cost Principles Internal Control / Segregation of Duties Questioned Costs

Finding Number 2023-037 Subject Heading (Financial) or AL no. and program name (Federal) 93.778 Medicaid Cluster 93.767 Children’s Health Insurance Program Planned Corrective Action OHCA MAGI Response: OHCA implemented system changes to begin income verification requests for all selfattested income ...

Finding Number 2023-037 Subject Heading (Financial) or AL no. and program name (Federal) 93.778 Medicaid Cluster 93.767 Children’s Health Insurance Program Planned Corrective Action OHCA MAGI Response: OHCA implemented system changes to begin income verification requests for all selfattested income from sources unable to be verified through existing data exchange. The system changes went to production on January 13, 2022 but were impacted by Public Health Emergency (PHE) requirements prohibiting termination of eligibility. The system changes became effective at the end of the PHE and have resulted in appropriate verification of income that was previously unverified. Guidance from Centers for Medicare and Medicaid Services (CMS) during the PHE prohibited the agency from requiring verification, renewals, or termination of Medicaid during the PHE. The agency followed the requirements and guidance of CMS throughout the PHE to ensure maintenance of coverage. OHCA is in the process of implementing system changes to ensure only previously verified income is removed and to ensure that applications in a pending status due to incomplete information from the Federal Marketplace continue to receive new data exchange information. OHCA continues to improve zero income self-attestation procedures as the value of the attestations in ensuring accurate eligibility decisions is recognized, and upgrades went to Production on April 17, 2025. Guidance from Centers for Medicare and Medicaid Services (CMS) during the PHE prohibited the agency from requiring verification, renewals, or termination of Medicaid during the PHE. The agency followed the requirements and guidance of CMS throughout the PHE to ensure maintenance of coverage. OHCA concurs with the Soon-to-be-Sooners (STBS) exception. The questioned costs will be reported on the CMS 64.9P line 10A on Cost of Service (COS) line 5 for the quarter ending June 30, 2025. OHCA Member Audit MAGI Response: Member Audit will complete three months of post-corrective action audits to ensure completion. If corrective action results are not sufficient, additional corrective action will be requested, and post- corrective action audit will be repeated. OKDHS Non-MAGI Response: For the non-MAGI deficiencies, OKDHS has addressed case issues through the establishment of a committee responsible for monitoring corrective actions and provided training to all appropriate employees. Additional informational webpages utilized by eligibility staff have been updated. OHCA Member Audit Non-MAGI Response: OHCA Member Audit has been monitoring these issues through monthly case reviews and provides feedback to OKDHS leadership. This process will continue until the issues have been corrected. Additional steps to correct issues are requested as deemed necessary by Member Audit. Anticipated Completion Date 8/31/2025 Responsible Contact Person Chris Dees, Eligibility and Coverage Services Technical Director April Anonsen, Deputy State Medicaid Director Ginger Clayton, OHCA Director of Member Audits Aubrey McDonald , OKDHS Medicaid Program Administrator Ginger Clayton, OHCA Director of Member Audits

View Audit 367158 Questioned Costs: $1

Finding 1154789 (2023-030)

Material Weakness 2023

Oklahoma Water Resources Board

OK

Questioned Costs Special Tests & Provisions Subrecipient Monitoring

Finding Number 2023-030 Subject Heading (Financial) or AL no. and program name (Federal) 93.778 Medicaid Cluster Planned Corrective Action Internal control processes and procedures to ensure MFCU overpayments are timely reported and refunded to the Center for Medicare and Medicaid Services (CMS) wer...

Finding Number 2023-030 Subject Heading (Financial) or AL no. and program name (Federal) 93.778 Medicaid Cluster Planned Corrective Action Internal control processes and procedures to ensure MFCU overpayments are timely reported and refunded to the Center for Medicare and Medicaid Services (CMS) were implemented beginning September 2024. These processes include collaborations with the Medicaid Fraud Control Unit at the Oklahoma Attorney General’s office quarterly to track the status of closed cases, obtain sufficient supporting documentation, and timely report and refund identified overpayments on the CMS- 64. Anticipated Completion Date 1/31/2025 Responsible Contact Person Kristine West, Senior Director of Program Integrity and Accountability

View Audit 367158

Finding 1154786 (2023-016)

Material Weakness 2023

Oklahoma Water Resources Board

OK

Questioned Costs Special Tests & Provisions Reporting

Finding Number 2023-016 Subject Heading (Financial) or AL no. and program name (Federal) 93.778 Medicaid Cluster Planned Corrective Action Program Integrity was actively implementing corrective action to ensure that all overpayments were reported within 12 months from identification when these cases...

Finding Number 2023-016 Subject Heading (Financial) or AL no. and program name (Federal) 93.778 Medicaid Cluster Planned Corrective Action Program Integrity was actively implementing corrective action to ensure that all overpayments were reported within 12 months from identification when these cases were closed. The errors associated with this finding were first reported on January 21, 2023 (Finding 2022-039) which resulted in OHCA developing corrective action to evaluate past cases and ensure all cases were reviewed and all overpayments were reported during the initial corrective action cycle. In all three instances related to late reporting of overpayments, all cases were reported on CMS-64.9c1 during implementation of corrective action plan as a result of the previous audit finding. One case was erroneously excluded during the corrective action plan. This finalized case was reported and refunded on the CMS-64.9OFWA, Line 1B for the quarter ending September 30, 2024 utilizing an average FMAP for all impacted programs. Internal procedures have been evaluated to ensure Service Quality Review overpayments are timely reported and refunded to the Center for Medicare and Medicaid Services (CMS). The cost of $4,007 questioned were reported on the CMS 64.9P line 10A on Cost of Service (COS) line 5 for the quarter ending March 31, 2025. Anticipated Completion Date 3/31/2025 Responsible Contact Person Kristine West, Senior Director of Program Integrity and Accountability

View Audit 367158 Questioned Costs: $1

Finding 1154784 (2023-003)

Material Weakness 2023

Oklahoma Water Resources Board

OK

Questioned Costs Allowable Costs / Cost Principles

Finding Number 2023-003 Subject Heading (Financial) or AL no. and program name (Federal) 93.778 Medicaid Cluster Planned Corrective Action OHCA will continue to utilize control processes and procedures to ensure medical claims are meeting program requirements. These processes include prior authoriza...

Finding Number 2023-003 Subject Heading (Financial) or AL no. and program name (Federal) 93.778 Medicaid Cluster Planned Corrective Action OHCA will continue to utilize control processes and procedures to ensure medical claims are meeting program requirements. These processes include prior authorizations, suspended claim reviews, system edits, post payment reviews, and our payment accuracy measurement study. OHCA will also continue National Correct Coding Initiative (NCCI) edit updates, as well as continue with provider training to better educate our providers. Partial costs questioned were reported on the September 30, 2024 and December 31, 2024 CMS 64.9C1, Line 5 ($64.62 and $312.47, respectively). The remaining $225.91 was reported on the CMS 64.9P, Line 10A on Cost of Service (COS) line 5 for the quarter ending March 31, 2025. Anticipated Completion Date 4/30/2025 Responsible Contact Person Kristine West, Senior Director of Program Integrity and Accountability

View Audit 367158 Questioned Costs: $1

Finding 1154739 (2023-004)

Material Weakness 2023

Oklahoma Water Resources Board

OK

Questioned Costs Allowable Costs / Cost Principles

Finding Number 2023-004 Subject Heading (Financial) or AL no. and program name (Federal) 93.767 Children’s Health Insurance Program Planned Corrective Action OHCA will continue to utilize control processes and procedures to ensure medical claims are meeting program requirements. These processes incl...

Finding Number 2023-004 Subject Heading (Financial) or AL no. and program name (Federal) 93.767 Children’s Health Insurance Program Planned Corrective Action OHCA will continue to utilize control processes and procedures to ensure medical claims are meeting program requirements. These processes include prior authorizations, suspended claim reviews, system edits, post payment reviews, and our payment accuracy measurement study. OHCA will also continue National Correct Coding Initiative (NCCI) edit updates, as well as continue with provider training to better educate our providers. The costs questioned were reported on the December 31, 2024 CMS 64.9C1, Line 5. Anticipated Completion Date 4/30/2025 Responsible Contact Person Kristine West, Senior Director of Program Integrity and Accountability

View Audit 367158 Questioned Costs: $1

Corrective Action Plans

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