Finding 1054310 (2023-011)

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

AI Summary

  • Core Issue: The County failed to conduct timely reviews of Medicaid eligibility after SSI terminations, resulting in ineligible recipients continuing to receive benefits.
  • Impacted Requirements: The County did not comply with Medicaid Manual MA-3120, which mandates initiating reviews within 5 days and completing them within 4 months.
  • Recommended Follow-Up: Improve communication between DSS departments, retrain staff on eligibility processes, and ensure all State communications are shared and acted upon promptly.

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: 2023-011 Untimely Review of SSI Termination SIGNIFICANT DEFICENCY Eligibility Criteria: Condition: Questioned Costs: Context: Effect: Cause: Identification of a repeat finding: Recommendation: Views of responsible officials and planned corrective actions: Section III. Federal Award Findings and Questioned Costs (continued) The County did not initiate ex parte review timely, therefore, no eligibility review was completed in the required time period. The lack of follow up and certification lead to applicants receiving Medicaid benefits for which they were not eligible. There was no known affect to eligibility and there were no known questioned costs. 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. In accordance with the Medicaid Manual MA-3120, the State sends notification to the County when a participant is no longer eligible under Supplemental Security Income (SSI) determination, the County is required to initiate the ex parte review within 5 workdays of the date the termination appears on the SSI Termination Report, and complete the redetermination within 4 months of the month the case appears on the SSI Termination Report and notify the recipient about applicant's ongoing eligibility for Medicaid. There was 2 applicant/beneficiary not reviewed timely and determined to be eligible for Medicaid when their SSI benefits were terminated, for which the recipient was not eligible. Any State communications related to applicants’ benefits received by any DSS department should be shared with all areas from which the participant receives benefits. State files should be reviewed internally to ensure all actions have been properly closed and the corrective action has been taken. Workers should be retrained on what process needs to be followed when State communications are received. The County agrees with the finding. This is a repeat finding from the immediate previous audit, 2022-007. Ineffective communication between departments within the Department of Social Services. One area within DSS received State communications that applicants would no longer be eligible for SSI benefits and the County needed to conduct an application process. This information was not shared with other departments in DSS from which the recipient was also receiving benefits.

Categories

Eligibility Reporting

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
  • 1054308 2023-009
    Significant Deficiency Repeat
  • 1054309 2023-010
    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