Finding Text
US Department of Health and Human Services
Passed through the NC Dept. of Health and Human Services
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL# 93.778
Finding: 2023-011 Non-cooperation with Child Support Procedures
SIGNIFICANT DEFICENCY
Eligibility
Criteria:
Condition:
Questioned Costs:
Context:
Effect:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL # 93.778
The Child Support Enforcement Agency (IV-D) can assist the family in obtaining financial and/or
medical support or medical support payments from the child’s non-custodial parent. Cooperation
requirement with Social Services and Child Support Agencies must be met or good cause for not
cooperating must be established when determining Medicaid eligibility.
There were 3 errors discovered during our procedures that referrals between DSS and Child Support
Agencies were not properly made.
There was no known affect to eligibility and there were no known questioned costs.
We examined 60 cases from of a total of 305,518 Medicaid claims from the Medicaid beneficiary
report provided by NC Department of Health and Human Services to re-determine 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 applicants could have been approved for benefits for
which they were not eligible.
Error in reading the ACTS report and/or ineffective case review process.
Section III. Federal Award Findings and Questioned Costs (continued)
SIGNIFICANT DEFICENCY: Finding 2023-007, 2023-008, 2023-009, 2023-010 and 2023-011 also apply to State requirements
and State Awards.
Section IV. State Award Findings and Questioned Costs
The County agrees with the finding. See the response in the corrective action plan.
Files should be reviewed internally to ensure proper information is in place and necessary procedures
are taken when determining eligibility. 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. See the response in the corrective action plan.