Finding 1054308 (2023-009)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2023
Accepted
2024-07-08
Audit: 314504
Organization: Vance County (NC)

AI Summary

  • Core Issue: Inaccurate information entry during eligibility determinations for Medicaid, leading to potential approvals for ineligible benefits.
  • Impacted Requirements: Compliance with 42 CFR 435 and 2 CFR 200, which mandate proper documentation and internal controls for eligibility assessments.
  • Recommended Follow-Up: Conduct internal reviews of files, retrain staff on documentation standards, and ensure all eligibility records include necessary verifications and clear case notes.

Finding Text

U.S. Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) AL #: 93.778 Finding: 2023-009 Inaccurate Information Entry SIGNIFICANT DEFICENCY Eligibility Criteria: Condition: Questioned Costs: Context: Effect: Cause: Identification of a repeat finding: Recommendation: Views of responsible officials and planned corrective actions: Files should be reviewed internally to ensure proper documentation is in place for eligibility. Workers should be retrained on what files should contain and the importance of complete and accurate record keeping. We recommend that all files include online verifications, documented resources of income and those amounts agree to information in NC FAST. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. The County agrees with the finding. We examined 60 cases from of a total of 804,789 Medicaid claims from the Medicaid beneficiary report provided by NC Department of Health and Human Services to redetermine eligibility. These findings are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST and a participant could have been approved for benefits for which they were not eligible. Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Section III. Federal Award Findings and Questioned Costs (continued) In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a recipient meets specific standards, and documentation must be maintained to support eligibility determinations. In accordance with 2 CFR 200, management should have an adequate system of internal controls procedures in place to ensure an applicant is properly determined or redetermined for benefits. There was no known affect to eligibility and there were no known questioned costs. There were 11 errors discovered during our procedures that inaccurate information was entered when determining eligibility. This is a repeat finding from the immediate previous audit, 2022-005.

Categories

Eligibility Internal Control / Segregation of Duties

Other Findings in this Audit

  • 477864 2023-007
    Significant Deficiency
  • 477865 2023-008
    Significant Deficiency Repeat
  • 477866 2023-009
    Significant Deficiency Repeat
  • 477867 2023-010
    Significant Deficiency Repeat
  • 477868 2023-011
    Significant Deficiency Repeat
  • 477869 2023-012
    Significant Deficiency Repeat
  • 1054306 2023-007
    Significant Deficiency
  • 1054307 2023-008
    Significant Deficiency Repeat
  • 1054309 2023-010
    Significant Deficiency Repeat
  • 1054310 2023-011
    Significant Deficiency Repeat
  • 1054311 2023-012
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
21.027 Coronavirus State and Local Fiscal Recovery Funds $2.25M
93.778 Medical Assistance Program $1.38M
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $747,788
93.568 Low-Income Home Energy Assistance $720,596
93.558 Temporary Assistance for Needy Families $392,319
93.667 Social Services Block Grant $355,409
93.658 Foster Care_title IV-E $206,987
93.563 Child Support Enforcement $194,507
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $171,400
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $152,960
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $82,937
93.659 Adoption Assistance $40,481
97.042 Emergency Management Performance Grants $39,032
16.738 Edward Byrne Memorial Justice Assistance Grant Program $30,771
93.767 Children's Health Insurance Program $16,869
93.053 Nutrition Services Incentive Program $16,531
93.645 Stephanie Tubbs Jones Child Welfare Services Program $10,627
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $10,209
93.052 National Family Caregiver Support, Title Iii, Part E $4,239
93.556 Promoting Safe and Stable Families $2,591
93.566 Refugee and Entrant Assistance_state Administered Programs $18