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FEDERAL AWARDS FINDING CORRECTIVE ACTION PLAN Year ended December 31, 2022 Finding 2022-003 Federal assistance listing number and name: 10.415 Rural Rent Housing Loans Awards numbers and years: 2022 Federal agency: United States Department of Agriculture Compliance Requirement: Special tests and pro...
FEDERAL AWARDS FINDING CORRECTIVE ACTION PLAN Year ended December 31, 2022 Finding 2022-003 Federal assistance listing number and name: 10.415 Rural Rent Housing Loans Awards numbers and years: 2022 Federal agency: United States Department of Agriculture Compliance Requirement: Special tests and provisions Questioned Costs: None Name of Contact Person and Title: Susie Kirker, Board Chair Criteria: Edgewater Estates did not maintain the replacement reserve funds in interest-bearing accounts in 2022. Condition and Context: The Project did not establish interest-bearing accounts for the replacement reserve funds as required by RD. Effect: RD projects are required to maintain interest bearing accounts for replacement reserve funds. Cause: The Project is not in compliance with RD regulations and procedures. Management Response: Management plans on establishing interest-bearing replacement reserve accounts in 2023. Status: In progress Anticipated Completion Date: Estimated 2023
FEDERAL AWARDS FINDING CORRECTIVE ACTION PLAN Year ended December 31, 2022 Finding 2022-002 Federal assistance listing number and name: 10.415 Rural Rent Housing Loans Awards numbers and years: 2022 Federal agency: United States Department of Agriculture Compliance Requirement: Equipment and Real Pr...
FEDERAL AWARDS FINDING CORRECTIVE ACTION PLAN Year ended December 31, 2022 Finding 2022-002 Federal assistance listing number and name: 10.415 Rural Rent Housing Loans Awards numbers and years: 2022 Federal agency: United States Department of Agriculture Compliance Requirement: Equipment and Real Property Management Questioned Costs: None Name of Contact Person and Title: Susie Kirker, Board Chair Criteria: Assets recorded on the financial statements should be supported by documentation showing the original cost or purchase price. Condition and Context: The Projects did not maintain adequate documentation to support the fixed assets recorded on the financial statements. Effect: The Projects are not in compliance with RD regulations or standards which require that assets recorded on the financial statements be supported with documentation showing the original purchase price or cost. Cause: The City of Poplar Housing Authority did not maintain adequate records to support the purchase price of the apartment buildings or the land on which the apartment buildings were built. Management Response: Management will continue to look for the supporting documentation for the original purchase price or cost of the Projects and the land on which the apartments were built. Status: In progress Anticipated Completion Date: Estimated 2023
FEDERAL AWARDS FINDING CORRECTIVE ACTION PLAN Year ended December 31, 2022 Finding 2022-001 Federal assistance listing number and name: 10.415 Rural Rent Housing Loans Awards numbers and years: 2022 Federal agency: United States Department of Agriculture Compliance Requirement: Special tests and pro...
FEDERAL AWARDS FINDING CORRECTIVE ACTION PLAN Year ended December 31, 2022 Finding 2022-001 Federal assistance listing number and name: 10.415 Rural Rent Housing Loans Awards numbers and years: 2022 Federal agency: United States Department of Agriculture Compliance Requirement: Special tests and provisions Questioned Costs: None Name of Contact Person and Title: Susie Kirker, Board Chair Criteria: Edgewater Estates and Combs Memorial did not establish or adequately fund the security deposit accounts in 2022. Condition and Context: Those Projects did not maintain the full amount of security deposit funds potentially owed to the tenants. Effect: The Projects are not in compliance with RD regulations and procedures. Cause: The Projects did not maintain the full amount of security deposit funds potentially owed to the tenants. Management Response: Management plans on fully funding the security deposit accounts for the amounts owed to tenants. Status: In progress Anticipated Completion Date: Estimated 2023
2022-003 - TIMELY SUBMISSION OF FEDERAL AUDIT CLEARINGHOUSE FILING (NON-COMPLIANCE) Corrective Action Planned: We will begin the auditing process in a timely fashion going forward and adhere to stricter timelines internally to prevent this from recurring. Anticipated Completion Date: March 31, 2024
2022-003 - TIMELY SUBMISSION OF FEDERAL AUDIT CLEARINGHOUSE FILING (NON-COMPLIANCE) Corrective Action Planned: We will begin the auditing process in a timely fashion going forward and adhere to stricter timelines internally to prevent this from recurring. Anticipated Completion Date: March 31, 2024
Finding ref number: 2022-001 Finding caption: The District did not have adequate internal controls for ensuring compliance with wage rate requirements. Name, address, and telephone of District contact person: Jeri Carlson 33330 8th Ave S Federal Way, WA 98003 253.945.2045 During the course of the...
Finding ref number: 2022-001 Finding caption: The District did not have adequate internal controls for ensuring compliance with wage rate requirements. Name, address, and telephone of District contact person: Jeri Carlson 33330 8th Ave S Federal Way, WA 98003 253.945.2045 During the course of the audit, the District immediately took steps to obtain and review all certified payroll documents from the beginning of the project to current and verified that the contractor was compliant with federal prevailing wage rules. This information was provided to the Auditors. The District has already taken steps to ensure the additional compliance steps are followed for federally funded construction projects. The District will also ensure staff are appropriately trained on these requirements.
Finding 2022-001 Summary: Although Horizon?s data collection form for the year end ended December 31, 2021 was not submitted to the FAC within the 30 days after the receipt of the auditor?s reports, that was more than nine months after the end of the audit period. The firm engaged by Horizon to p...
Finding 2022-001 Summary: Although Horizon?s data collection form for the year end ended December 31, 2021 was not submitted to the FAC within the 30 days after the receipt of the auditor?s reports, that was more than nine months after the end of the audit period. The firm engaged by Horizon to prepare the report was hard hit with staffing issues and Covid and they were severely behind schedule. Corrective Action: Horizon has engaged a different firm to prepare the 2022 report. They plan to provide the report to Horizon in August, 2023 and Horizon will submit the data collection form within 30 days thereafter in compliance with the law. Contact Person: Sharon Knaggs, CFO Anticipated Completion Date: August 31, 2023.
Date: April 21, 2023 Subject: Corrective Action Plan Please find below the Medical University of South Carolina?s (MUSC) Corrective Action Plan for the finding presented by KPMG relating to our fiscal year 2022 audit conducted under the Uniform Guidance. Audit finding reference number: 2022-003 Ca...
Date: April 21, 2023 Subject: Corrective Action Plan Please find below the Medical University of South Carolina?s (MUSC) Corrective Action Plan for the finding presented by KPMG relating to our fiscal year 2022 audit conducted under the Uniform Guidance. Audit finding reference number: 2022-003 Cash Management Cause and potential effect as presented in the Summary of Findings and Questioned Costs: For 3 of the 40 samples tested, taxes were properly accrued as allowable costs but were drawn prior to payment by the University. While these costs are deemed allowable, they were not paid for prior to seeking reimbursement from the federal agency. The taxes drawn prior to payment totaled $4,035 out of a total of $784,941 tested in the sample of 40. The control to ensure that all costs were paid for prior to seeking reimbursement was not operating effectively to identify instances of noncompliance related to the applicable taxes. Name(s) of the contact person(s) responsible for corrective action: Velma G. Stamp, Director, Grants and Contracts Accounting Michael Laird, Manager, Financial Reporting, Grants and Contracts Accounting Corrective action planned: MUSC tested purchases to determine the extent of the finding. It was found that this issue was isolated to the Department of Lab Animal Research (DLAR) animal purchases made with the departmental Purchasing Card. Once this determination was made all DLAR animal purchasing card transactions were identified, for the period being audited, in order to calculate the use tax required to be paid. MUSC?s tax office then submitted amendments for each month, remitting the additional use tax as well as the applicable penalties to the South Carolina Department of Revenue. No adjustments were needed to be made to the grants impacted as these are otherwise allowable costs. We believe MUSC?s system operates adequately when use tax is flagged as required by our policies and procedures. This instance occurred due to input errors by the employee responsible for this area. As such, we have conducted training with the employee as well as the employee?s manager instructing how purchasing card transactions subject to use tax must be identified when allocating credit card purchases. In addition, we will monitor DLAR credit card purchases to ensure MUSC?s policies and procedures are being adhered to. Anticipated completion date: This corrective action has been implemented and the monitoring will be ongoing. Questions or requests for additional information related to this Corrective Action Plan may be directed to me via email at stampvg@musc.edu or by telephone at 843-792-3657. Sincerely, Velma G. Stamp, Director
View Audit 19410 Questioned Costs: $1
Date: March 28, 2023 Subject: FY22 Summary Schedule of Audit Findings As referenced in the FY22 Summary of Findings and Questioned Costs Year ended June 30, 2022, this narrative addresses a corrective action plan related to the finding listed below. Reference 2022-002 Finding Cash Management ...
Date: March 28, 2023 Subject: FY22 Summary Schedule of Audit Findings As referenced in the FY22 Summary of Findings and Questioned Costs Year ended June 30, 2022, this narrative addresses a corrective action plan related to the finding listed below. Reference 2022-002 Finding Cash Management Status See Narrative Contact Person: Velma Stamp Cause and potential effect as presented in the Summary of Findings and Questioned Costs: The control to ensure that disbursements for the Student Aid Portion and the Institutional Aid Portion were occurring on a timely basis was not operating effectively to ensure timely disbursement. Narrative Explanation: For CRRSAA HEERF II and ARP HEERF III, the Certification and Agreements and/or Supplemental Agreements requires that Student Aid Portion (ALN 84.425E) should be disbursed within 15 calendar days of the drawdown from ED?s G5 grants system and Institutional Aid Portion, (a)(2), and (a)(3) funds (all other ALNs) should be disbursed within 3 calendar days of the drawdown from G5. This was a new requirement that was only understood by a few within the institution. Unfortunately, this information did not fully cascade to all areas who were spending funds. Corrective action: While this award has ended, should we receive similar type of awards in the future our new Enterprise Resource Planning (ERP) system will allow us to put controls in place to ensure timely distribution. You may direct questions to me at stampvg@musc.edu or by telephone at 843-792-3657. Best Regards, Velma G. Stamp Director, Grants and Contracts Accounting cc: Mike McGinnis, MBA, Assistant Provost for Finance and Administration Suzanne Thomas, PhD, Associate Provost for Educational Planning and Effectiveness Melissa Halcomb, MSM, Executive Director for Enrollment Management
COMMENT COMMENT CORRECTIVE ACTION PLAN CONTACT PERSON, TITLE, ANTICIPATED DATE REFERENCE TITLE PHONE NUMBER OF COMPLETION 2022-001 SEGREGATION ...
COMMENT COMMENT CORRECTIVE ACTION PLAN CONTACT PERSON, TITLE, ANTICIPATED DATE REFERENCE TITLE PHONE NUMBER OF COMPLETION 2022-001 SEGREGATION SEE RESPONSE AND CORRECTIVE TERESA SADLER N/A DUTIES ACTION PLAN AT 2022-001. BUSINESS MANAGER 515-448-4749 2022-002 PREPARATION SEE RESPONSE AND CORRECTIVE TERESA SADLER N/A OF FINANCIAL ACTION PLAN AT 2022-002. BUSINESS MANAGER STATEMENTS 515-448-4749
Finding 23564 (2022-075)
Significant Deficiency 2022
The Agency acknowledges the finding and recommendation. The Agency will review finding and recommendation with the Federal Disaster Grant award agency. The Agency will outline the Disaster Grant Process and adjust reporting requirements as required. Anticipated Completion Date: September 1, 2023 ...
The Agency acknowledges the finding and recommendation. The Agency will review finding and recommendation with the Federal Disaster Grant award agency. The Agency will outline the Disaster Grant Process and adjust reporting requirements as required. Anticipated Completion Date: September 1, 2023 Contact Person: Armand Randolph, Recovery Branch Chief Rhode Island Emergency Management Agency armand.randolph@ema.ri.gov
Finding 23548 (2022-074)
Significant Deficiency 2022
2022-074a ? EOHHS will implement an enhanced invoice review documentation requirements for significant contractor invoices to ensure compliance with Uniform Guidance requirements over allowable costs in the Medicaid Program. 2022-074b ? EOHHS will improve procedures to ensure that recoupments are m...
2022-074a ? EOHHS will implement an enhanced invoice review documentation requirements for significant contractor invoices to ensure compliance with Uniform Guidance requirements over allowable costs in the Medicaid Program. 2022-074b ? EOHHS will improve procedures to ensure that recoupments are made for identified special education services deemed unallowable for Medicaid reimbursement. Anticipated Completion Date: December 2023 Contact Persons: Jason Lyon, Administrator for Medical Services Executive Office of Health and Human Services jason.lyon@ohhs.ri.gov Christopher Smith, Director of Program Integrity Executive Office of Health and Human Services christopher.smith@ohhs.ri.gov
View Audit 23102 Questioned Costs: $1
Finding 23547 (2022-073)
Significant Deficiency 2022
2022-073a ? EOHHS submitted a State Plan Amendment to CMS to codify the PRTF reimbursement methodology on June 29, 2021. Since 2021, EOHHS and DCYF have been working to respond to CMS comments, including updating the cost report to be used by PRTF providers and amending the proposed State Plan lang...
2022-073a ? EOHHS submitted a State Plan Amendment to CMS to codify the PRTF reimbursement methodology on June 29, 2021. Since 2021, EOHHS and DCYF have been working to respond to CMS comments, including updating the cost report to be used by PRTF providers and amending the proposed State Plan language to address CMS questions on the reimbursement methodology. Anticipated Completion Date: EOHHS anticipates CMS approval of the State Plan Amendment before June 30, 2023. 2022-073b ? EOHHS will continue to work with DCYF to ensure that allowable medical services provided by DCYF providers are billed directly to the MMIS and subject to all designed claims processing, recipient eligibility, and provider eligibility controls. Anticipated Completion Date: Ongoing Contact Person: Dezeree Hodish, Assistant Director, Financial and Contract Management Executive Office of Health and Human Services dezeree.hodish@ohhs.ri.gov
View Audit 23102 Questioned Costs: $1
Finding 23546 (2022-072)
Significant Deficiency 2022
2022-072a ? Gainwell Technologies (our MMIS Fiscal Intermediary) has contacted their internal audit team to determine next steps for the inclusion of NCCI testing in the 2024 SOC Audit (Audit period 7/2023-6/2024). A meeting has been scheduled for May 2, 2023 to discuss this. Upon review of the 20...
2022-072a ? Gainwell Technologies (our MMIS Fiscal Intermediary) has contacted their internal audit team to determine next steps for the inclusion of NCCI testing in the 2024 SOC Audit (Audit period 7/2023-6/2024). A meeting has been scheduled for May 2, 2023 to discuss this. Upon review of the 2021 finding in February of 2022, Gainwell researched if this was implemented in any other Gainwell account?s SOC1 audit and were advised that industry standards do not include NCCI edit reviews in SOC auditing. EOHHS/Medicaid will provide additional details as they become available. Anticipated Completion Date: Ongoing 2022-072b ? The requirements outlined in the NCCI Medicaid Technical Guidance issued by CMS will be incorporated throughout Rhode Island?s procurement of a new Medicaid Management Information System which is scheduled to commence with development of requirements, scopes of work, and RFPs beginning in May 2023 and is projected to continue through mid-2029 with the completion of certification of all functional modules. Anticipated Completion Date: Ongoing 2022-072c ? MC Oversight put the provision for NCCI compliance edits in the MCO contracts to be effective 7/1/23. This contract amendment will be going out this week (week of 4/24/2023) to the MCOs. We would need to look on an implementation timeline (as with the TPL findings) with the MCOs later this summer/fall regarding any testing they need to do with these new compliance edits for encounter data. Anticipated Completion Date: July 1, 2023 Contact Persons: Hector Rivera, Interdepartmental Project Manager Executive Office of Health and Human Services hector.l.rivera@ohhs.ri.gov Charles Estabrook, Managed Care Administrator Executive Office of Health and Human Services charles.estabrook@ohhs.ri.gov
Finding 23545 (2022-071)
Significant Deficiency 2022
EOHHS submitted a State Plan Amendment for CMS review January 30, 2023. The amendment would remove the triennial rate review and clarify in what situations EOHHS would review nursing facility financial records. Anticipated Completion Date: EOHHS is awaiting a response from CMS on its State Plan Am...
EOHHS submitted a State Plan Amendment for CMS review January 30, 2023. The amendment would remove the triennial rate review and clarify in what situations EOHHS would review nursing facility financial records. Anticipated Completion Date: EOHHS is awaiting a response from CMS on its State Plan Amendment submission. EOHHS expects a response before June 30, 2023. Contact Person: Dezeree Hodish, Assistant Director, Financial and Contract Management Executive Office of Health and Human Services dezeree.hodish@ohhs.ri.gov
In collaboration with DLT and its IES vendor, EOHHS has made plans to move the RI Bridges PEV data query to a later date in the month to ensure PEV occurs after the quarterly DLT SWICA refresh date. This will ensure EOHHS is capturing more delinquent wage records (reported late by employers) before...
In collaboration with DLT and its IES vendor, EOHHS has made plans to move the RI Bridges PEV data query to a later date in the month to ensure PEV occurs after the quarterly DLT SWICA refresh date. This will ensure EOHHS is capturing more delinquent wage records (reported late by employers) before the file is sent. EOHHS and DLT are also assessing an option to add a monthly SWICA update file in addition to the existing quarterly file. Furthermore, EOHHS is pursuing system enhancements to integrate state wage data provided by Equifax?s The Work Number (TWN) to RI Bridges. Adding TWN data, which is provided by pay period, to quarterly SWICA files would enable RI Bridges to process renewals and validate post-eligibility income with more frequently available wage data. Anticipated Completion Date: To Be Determined. EOHHS and DLT continue to discuss technical aspects of a monthly update file exchange. System requirements to integrate Equifax TWN data is included in Medicaid?s SFY24 Annual Planning process and will be scheduled for deployment later in CY2024. Contact Person: Brian Tichenor, RIBridges Medicaid Administrator Executive Office of Health and Human Services brian.tichenor@ohhs.ri.gov
2022-069a ? There are ongoing projects efforts with the Gainwell Technologies (the MMIS Fiscal Agent) to clean up the gaps in the TPL process that leads to inaccurate TPL data within the MMIS, those projects include: ? Changing the logic in the MMIS to end date members active TPL segments when Medic...
2022-069a ? There are ongoing projects efforts with the Gainwell Technologies (the MMIS Fiscal Agent) to clean up the gaps in the TPL process that leads to inaccurate TPL data within the MMIS, those projects include: ? Changing the logic in the MMIS to end date members active TPL segments when Medicaid eligibility is lost ? Cleaning up active TPL segments for members with dates of death in the MMIS ? Project request to clean up inaccurate Policy begin dates that are being changed by incoming ?MMA file? (From CMS) data ? Project to update coverage type codes for Medicare Advantage plans to have their own distinct code ? Expanding logic on MMA file to include more Medicaid members so more Medicare information can be taken in by the MMIS Additionally, there is work with Deloitte and Gainwell to ensure we have accurate TPL information within the RIBridges system. 2022-069b ? EOHHS has worked with Gainwell Technologies (the MMIS Fiscal Agent) to supply the MCOs with monthly files that include their enrolled members who have active TPL information within MMIS. These files have been generated and QCd by the systems team. We are currently in process with the MCO team to determine how these files will be delivered to the MCOs and define the expectations of how the MCOs use these files. Anticipated Completion Date: December 2024 Contact Person: Jeffrey Schmeltz, Chief of Family Health Systems Executive Office of Health and Human Services jeffrey.schmeltz@ohhs.ri.gov
View Audit 23102 Questioned Costs: $1
Finding 23521 (2022-068)
Significant Deficiency 2022
2022-068a ? EOHHS addressed issues with the TPL loopback file between MMIS and RI Bridges with a permanent system fix. 2022-068b ? EOHHS will assess the current process of Medicaid Administration claiming and develop a revised process to require HHS agencies to submit the reconciliations of their q...
2022-068a ? EOHHS addressed issues with the TPL loopback file between MMIS and RI Bridges with a permanent system fix. 2022-068b ? EOHHS will assess the current process of Medicaid Administration claiming and develop a revised process to require HHS agencies to submit the reconciliations of their quarterly reports to reported expenditures in RIFANS. In addition, the RIFANS documentation will be reviewed and approved prior to submission of the federal report. 2022-068c ? EOHHS will conduct this analysis and create a process to report the MCO tax on the CMS 64.11A. Anticipated Completion Date: December 2023; TPL loopback deployed into RI Bridges production on 5/19/2022. Contact Persons: Brian Tichenor, RIBridges Medicaid Administrator Executive Office of Health and Human Services brian.tichenor@ohhs.ri.gov Allison Shartrand, Assistant Director Financial and Contract Management Executive Office of Health and Human Services allison.shartrand@ohhs.ri.gov Chaz Plungis, Chief of Strategic Planning, Monitoring and Evaluation Executive Office of Health and Human Services charles.plungis@ohhs.ri.gov
2022-067a ? In amendment 5 with the health plans, signed in the fall of 2021, EOHHS strengthened its contractual requirements with the health plans by requiring the plans to reconcile differences between claims submitted and accepted via the encounter submission process to encounterable claims as re...
2022-067a ? In amendment 5 with the health plans, signed in the fall of 2021, EOHHS strengthened its contractual requirements with the health plans by requiring the plans to reconcile differences between claims submitted and accepted via the encounter submission process to encounterable claims as reported in the quarterly financial data cost reports within 0.1%. The contract at section 2.13.02.04 includes the following language: ?Contractor is responsible to reconcile Financial Data Cost Report (FDCR) cost allocations and the File Submission Report (FSR), which contains the encounter data reporting outlined above. The reported Incurred Expenditures submitted in the File Submission Report must align with the sum of the Direct Paid, Non-State Plan Paid, and Subcapitated Proxy Paid expenditures submitted in the Financial Data Cost Report for each state fiscal year within the point one percent (.1%) threshold. The FSR and FDCR used for this comparison will include the same paid run-out period. Failure to meet threshold will result in financial penalty and/or corrective action by EOHHS as outlined in ?Rhode Island Medicaid Managed Care Encounter Data Methodology, Thresholds and Penalties for Non-Compliance.?? Achieving this level of compliance has proven more difficult than anticipated. To date, EOHHS has not imposed any financial penalties as a result of this new requirement. We have, however, worked proactively with the health plans to resolve outstanding issues and reconcile differences. EOHHS staff meet with managed care staff regularly throughout the month to resolve issues that arise during the claims submission process and to determine the root cause for claim rejections. This work is ongoing. EOHHS plans to further strengthen its oversight and improve plan compliance with the procurement of the managed care contracts. That revised encounter data quality plan, which is subject to further modification into the fall as we prepare the revised procurement documentation, is available on EOHHS?s website, here: https://eohhs.ri.gov/sites/g/files/xkgbur226/files/2021-10/4.1-rhode-island-medicaid-managed-care-encounter-data-quality-measurement-20210826.pdf Anticipated Completion Date: Ongoing Contact Person: Bill McQuade, Chief of Program Analytics Executive Office of Health and Human Services bill.mcquade@ohhs.ri.gov 2022-067b ? Over the course of the last two FY audits, EOHHS continued to make improvements to automatically identify and terminate Medicaid eligibility for deceased individuals. EOHHS has completed root cause analysis and has submitted business requirements for SFY24 Annual Planning to resolve downstream issues in the MMIS when Date of Death (DoD) is not received from RI Bridges or associated interface. EOHHS has submitted both an interim business plan (IBP) and permanent system interface modification to align date of death data between RI Bridges and MMIS. Anticipated Completion Date: Ongoing. IBP is scheduled for implementation in June 2023, while the permanent system modification will be scheduled later in CY2024 post SFY24 annual planning decisions. Contact Person: Brian Tichenor, RIBridges Medicaid Administrator Executive Office of Health and Human Services brian.tichenor@ohhs.ri.gov
View Audit 23102 Questioned Costs: $1
EOHHS in partnership with is Fiscal Agent who manages our provider enrollment unit, have engaged in a project with our Managed Care Organizations to appropriately enroll and screen providers who are enrolled and credentialed in managed care networks. There have been four (4) mailing waves in which ...
EOHHS in partnership with is Fiscal Agent who manages our provider enrollment unit, have engaged in a project with our Managed Care Organizations to appropriately enroll and screen providers who are enrolled and credentialed in managed care networks. There have been four (4) mailing waves in which approximately ~24,000 letters were sent to providers by the MCOs requesting their providers to enroll. Currently, MCOs are reporting an in-network RI Medicaid screened compliance percentage of seventy-eight percent (78%). Additionally, EOHHS and the Fiscal agent have developed encounter edits to reject encounters if an MCO submits and encounter for an in-network provider, that has enrolled with an MCO but has not been screen by RI Medicaid after one-hundred twenty (120) days from enrollment with said MCO. Additional edits were put in place to reject encounters for out of network providers who provide more than one (1) instance of care to an individual and have not been screened by RI Medicaid. EOHHS has updated MCO contracts to reflect compliance with this requirement and requested the MCOs being reviewing networks and network adequacy requirements to comply with Cures Act requirements. Anticipated Completion Date: June 30, 2023 Contact Persons: Matt Kiehnle, Administrator for Medical Services Executive Office of Health and Human Services matthew.kiehnle@ohhs.ri.gov Chantele Rotolo, Managed Care Special Project Coordinator Executive Office of Health and Human Services chantele.rotolo@ohhs.ri.gov
EOHHS has contracted with its External Quality Review Organization (EQRO) to conduct an audit of encounter data claims starting in May 2022. This will be conducted every three (3) years per requirements. EOHHS will modify its contract to ensure compliance with annual audited financial reports spec...
EOHHS has contracted with its External Quality Review Organization (EQRO) to conduct an audit of encounter data claims starting in May 2022. This will be conducted every three (3) years per requirements. EOHHS will modify its contract to ensure compliance with annual audited financial reports specific to the Medicaid contract on an annual basis. CMS concurs with the recommendation and the State?s CAP and requests that within thirty days the state provide documentation to support any completed actions and procedures put in place to support the described CAPs. If the state contends it is still working on implementing the additional policies and procedures, please propose an expected date for full implementation. EOHHS is currently under the review process with the contracted vendor. EOHHS is completing an encounter data audit related to EOHHS? oversight of claims related to claims incurred by MCOs to support data and financial oversight. EOHHS anticipates the review process to be complete by end of the SFY. EOHHS is amending contracts to reflect financial audit per the finding. EOHHS' contract EQRO has begun the encounter data audit and anticipated to complete audit of encounter data on 7/1/23. Anticipated Completion Date: July 2023 Contact Persons: Mark Kraics, Deputy Medicaid Director, Managed Care Oversight & Behavioral Health Executive Office of Health and Human Services mark.kraics@ohhs.ri.gov Charles Estabrook, Managed Care Administrator Executive Office of Health and Human Services charles.estabrook@ohhs.ri.gov Lynn Doherty, Managed Care Compliance Officer Executive Office of Health and Human Services lynn.doherty@ohhs.ri.gov
2022-064a ? Over the course of the last two FY audits, EOHHS continued to make system improvements for controls over CHIP eligibility determinations. In response to the OAG finding two individuals out of the 40 tested covered by existing health coverage at the time of the claim, EOHHS assessed that...
2022-064a ? Over the course of the last two FY audits, EOHHS continued to make system improvements for controls over CHIP eligibility determinations. In response to the OAG finding two individuals out of the 40 tested covered by existing health coverage at the time of the claim, EOHHS assessed that one case didn?t have TPL data in Bridges due to HMO loopback file not being operational at time of OAG?s audit. The other case had eligibility run prior to the deployment of the TPL system fix on 5/19/2022. With regard to the lack of documentation for citizenship of one individual considered ineligible, EOHHS determined that this was an older case converted from InRhodes and never had eligibility run by a worker/member in RI Bridges. All eligibility runs were from mass update, which doesn?t hit the SSA composite to verify citizenship; therefore when OAG reviewed this case, auditor was not able to view that citizenship had been verified. The case has since had their eligibility run by a worker and citizenship has been verified. 2022-064b ? EOHHS will return the federal funds to the feds in June 2023. Anticipated Completion Date: EOHHS addressed issues with the TPL loopback file between MMIS and RI Bridges with a permanent system fix ? deployed into RI Bridges production on 5/19/2022. Contact Person: Brian Tichenor, RIBridges Medicaid Administrator Executive Office of Health and Human Services brian.tichenor@ohhs.ri.gov
View Audit 23102 Questioned Costs: $1
DHS OCC is currently working with the Office of Internal Audits (OIA), DHS Collections, Claims and Recovery Unit (CCRU), Policy and Legal teams to review/update the existing DHS/OIA MOU and to operationalize recapture of overpayments resulting from fraudulent practices. CCAP regulations were update...
DHS OCC is currently working with the Office of Internal Audits (OIA), DHS Collections, Claims and Recovery Unit (CCRU), Policy and Legal teams to review/update the existing DHS/OIA MOU and to operationalize recapture of overpayments resulting from fraudulent practices. CCAP regulations were updated in 2018 to state that unintentional/error based overpayments to families would be reclaimed by CCRU and unintentional/error based overpayments to providers would be reclaimed by OCC Financial Management. This would require manual processing pending RIBridges functionality updates. In cases where OIA issues a determination of IPV/fraud OIA will refer the case to CCRU for collection and recoupment. Anticipated Completion Date: April 2024 Contact Person: Sharon Fitzgerald, CCAP Administrator Department of Human Services sharon.fitzgerald@dhs.ri.gov
View Audit 23102 Questioned Costs: $1
The Office of Child Care (OCC) has reviewed available training materials related to CCAP eligibility and case processing and has identified certain gaps where additional training/clarification, and more frequent communication to processing staff is needed ? specifically in income calculation/input o...
The Office of Child Care (OCC) has reviewed available training materials related to CCAP eligibility and case processing and has identified certain gaps where additional training/clarification, and more frequent communication to processing staff is needed ? specifically in income calculation/input of paystubs, confirming asset declarations and confirming need hours. OCC has requested to work with CSDL to create a CCAP specific training to provide in-depth coverage of program requirements. OCC has presented at quarterly meetings to highlight error findings and the critical importance of accurate documentation ? specifically citizenship of the child and residency. OCC works continuously with field staff and Deloitte through weekly theme meetings to identify areas where system changes can improve accuracy of eligibility determinations. OCC is currently reviewing the grace period/short-term approval policy, how it is applied to specific cases and how it is implemented in RIBridges. Anticipated Completion Date: April 2024 Contact Person: Sharon Fitzgerald, CCAP Administrator Department of Human Services sharon.fitzgerald@dhs.ri.gov
View Audit 23102 Questioned Costs: $1
School Policy establishes purchase procedures for school employees. These procedures describe the proper documentation necessary for purchases being made using school funds. A recommendation will be made that any employee making a purchase on the school?s behalf that fails to provide proper document...
School Policy establishes purchase procedures for school employees. These procedures describe the proper documentation necessary for purchases being made using school funds. A recommendation will be made that any employee making a purchase on the school?s behalf that fails to provide proper documentation of the purchase will be made to reimburse the school for the amount within a specified time frame to be determined by the School Board.
View Audit 19976 Questioned Costs: $1
Management concurs with the finding. The year-end closing process has improved significantly over the past years and we will continue to strengthen controls over financial reporting to reduce the time required to perform year-end analyses and the closing process. Specifically, analyses and adjustmen...
Management concurs with the finding. The year-end closing process has improved significantly over the past years and we will continue to strengthen controls over financial reporting to reduce the time required to perform year-end analyses and the closing process. Specifically, analyses and adjustments to contract obligations and purchase orders will be performed on a quarterly basis to complete the reconciliation of year-end balances and transactions in July, within the time constraint. In addition, the Municipality immediately implemented a three-step quality control to the quarterly report?s submission (Preparer / Reviewer / Approval) to ensure that the amounts reported are in accordance with the accounting records. IMPLEMENTATION DATE Ongoing Process RESPONSIBLE PERSON Finance Department
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