U.S. Department of Health and Human Services (DHHS) Maryland Department of Health respectfully submits the following corrective action plan for the year ended June 30, 2024. Audit period: July 1, 2023 – June 30, 2024 The findings from the schedule of findings and questioned costs are discussed below...
U.S. Department of Health and Human Services (DHHS) Maryland Department of Health respectfully submits the following corrective action plan for the year ended June 30, 2024. Audit period: July 1, 2023 – June 30, 2024 The findings from the schedule of findings and questioned costs are discussed below. The finding is numbered consistently with the numbers assigned in the schedule. FINDINGS—FEDERAL AWARD PROGRAMS AUDITS Maryland Department of Health 20XX-XXX Medicaid Cluster – Assistance Listing No. 93.775, 93.777, 93.778 Children Health Insurance Program – Assistance Listing No. 93.767 Recommendation: We recommend that the Department enhance its procedures and internal controls to ensure that overpayments are reported to CMS either in the quarter in which the recovery is made or in the quarter in which the one-year period following discovery ends, whichever is earlier. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Name(s) of the contact person(s) responsible for corrective action: Planned completion date for corrective action plan 20XX-XXX Medicaid Cluster – Assistance Listing No. 93.775, 93.777, 93.778 Recommendation: We recommend that the Department enhance its procedures and internal controls to ensure that RAC desk and field audits are performed timely and that overpayments are recouped. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding:. #1: The Department will direct the RAC vendor to begin all new audits using the current universe of available claims from MMIS II including claims from calendar years 2022-2024. This will ensure timely performance of audits and that overpayments are recouped. The Department will direct the current vendor to request the parameters for the claims from the RAC Contract Monitor and support in the transfer of these claims, so that the RAC vendor may begin including them in new audits that begin after April 1, 2025 through the end of their contract. #2: In addition, the RAC Contract Monitor will work with the Office of Contract Management and Procurement (OCMP) to determine if a contract modification is also needed/recommended to ensure timeliness of claims reviewed in RAC audits going forward, and if so, execute the needed contract modification. #3: Finally, the requirement to audit the most recent available claims will be included as language in the new Request for Proposals (RFP) for a RAC vendor that is expected to be issued in 2025. This RFP will be a competitive procurement to select the next contracted RAC vendor, and as such, will ensure this requirement for timely auditing of providers is maintained going forward regardless of which vendor is selected. Name(s) of the contact person(s) responsible for corrective action: Sandy Kick, Director, OMBM and Lynn Price, RAC Contract Monitor Planned completion date for corrective action plan: #1 & #2: June 30, 2025; #3: December 30, 2025 (expected to issue RFP). If the U.S DHHS has questions regarding this plan, please call Sandy Kick at 410-767-5248 or Lynn Price at (667) 208-0776.