Corrective Action Plan For the Year Ended June 30, 2022 Finding: 2022-001 Jessica Murphy, Team Leader, Special Investigations Significant Deficiency, nonmaterial noncompliance Special Tests and Provisions (Enterprise Program Integrity) Per the North Carolina DSS Crosscutting Requirements compliance ...
Corrective Action Plan For the Year Ended June 30, 2022 Finding: 2022-001 Jessica Murphy, Team Leader, Special Investigations Significant Deficiency, nonmaterial noncompliance Special Tests and Provisions (Enterprise Program Integrity) Per the North Carolina DSS Crosscutting Requirements compliance supplement, counties must acquire case documentation to substantiate the claim entry into the NC FAST Enterprise Program Integrity (?EPI?) system, including the budget and budget calculation sheets used to compute the amount of the overpayment. In one stance of a Food and Nutrition Services claim entered in EPI, there was not adequate case documentation to substantiate the claim and the budget calculated during the initial investigation in the claims file did not agree to the amount that was entered in EPI to be collected on by the county. This claim has since been reviewed, the budget was corrected and the amount in the EPI system, as well as the casefile, was updated. In order to prevent subsequent instances of this issue occurring, DSS Program Integrity staff will implement the following internal control measures effective 1/1/2023: ? Review and evaluate current DSS-1682 Report of Erroneous Issuance form for errors and miscalculations. In reviewing the case in which the error occurred, it was discovered that the DSS-1682 had a formula error in which the amounts did not total correctly on the spreadsheet. Therefore, the incorrect overpayment amount was entered into the EPI system. The DSS-1682 will be reviewed and updated to show the correct formula calculations and the previously-used incorrect form will be removed from usage by staff by 12/31/22. ? Additional second-party and third-party reviewing processes for overpayment claims. In the identified case finding, a second-party review was completed, as are all overpayment claims per Food and Nutrition Services policy, however this instance revealed that additional review, in the form of a third-party can provide a reduced risk-factor as the error could have been discovered by the additional review. Effective 1/1/23, all overpayment claims must be submitted for second-party review and third-party review prior to submission into the NC FAST EPI system. ? Revised case review tools. There is currently not a detailed, itemized review form that is used for Program Integrity. The current tool does have specifications for the evaluation of the overpayment calculation; however, it does not have additional indicators to allow for consistency in reviewing the specified overpayment months, program integrity budgets, financial transactions, and correct allotment amounts. In observation of this, it has been determined that a new case record review tool will be created and implemented effective 1/1/23. The proposed effect of this form will be that additional review and inquiry will be completed by the second party reviewer and the third-party reviewer and there will be increased compliance in regards to overpayment claim calculation. The planned controls have the projected effect of reducing the risk of overpayment calculation errors, incorrect budgeting, and invalid claim amounts entered into the NC FAST EPI system. Proposed completion: All measures effective 1/1/23 and ongoing.