Finding 1055723 (2023-005)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2023
Accepted
2024-07-24

AI Summary

  • Core Issue: The ADP security plan is not implemented or tested, risking critical business functions during emergencies.
  • Impacted Requirements: SMAs must conduct periodic risk analyses and biennial security reviews, which are currently lacking.
  • Recommended Follow-Up: The SMA should perform independent audits of Managed Care Organizations every three years and ensure results are publicly posted.

Finding Text

Criteria SMAs must establish and maintain a program for conducting periodic risk analyses to ensure appropriate and cost-effective safeguards are incorporated into new and exjsting systems. State agencies must perfollTl risk analyses whenever significant system changes occur. SMAs shall review ADP system security installations involved in the administration of HHS programs on a biennial basis. At a minimum the revjews shall include an evaluation of physical and data security operating procedures and personnel practices. The SMA shall maintain reports on its biennial ADP system security reviews, together with pertinent supporting documentation, for HHS on-site reviews (45 CFR section 95.621). Condition The security plan for ADP (Automatic Data Processing) system, including policies and procedmes to address contingency plans in the event of unforeseen interruptions has not been implemented and tested. Cause This situation was primarily caused by the lack of effective internal control over ADP Risk Analysis and System Security Review. Effect Critical business functions may not be resumed on time in case an emergency or disaster causes the ADP system resources to become unable to meet critical processing needs in the event of a short or long-term interruption of service. Questioned Costs None Prior Year Audit Finding 2022-007 Recommendation The State Medical Agency (SMA) should carry-out or contract to perform independent audit no less than once every three years to each Manage Care Organizations to validate the accuracy, truthfulness, and completeness of the financial information submitted, and post the results on its websites. Views of Responsible Officials The DOH disagrees with this finding as they believe the MCO should have received a SOC 1 Type I and Type 2 Report. The DOH has requested this information from the MCO however it has not been provided yet due to the short time frame for gathering the requested information. Responsible Officials Dinorah Collazo Ortiz Felmarie Cruz Morales Marcia Berrios De La Torre Estimated Completion Date Executive Director Fiscal Director Financial Advisor 787-765-2929 ext. 3402 787-765-2929 ext. 6721 787-765-2929 ext. 6746 Implementation is expected to be completed on or before the end of the year 2025.

Categories

Internal Control / Segregation of Duties

Other Findings in this Audit

  • 479252 2023-001
    Material Weakness Repeat
  • 479253 2023-001
    Material Weakness Repeat
  • 479254 2023-001
    Material Weakness Repeat
  • 479255 2023-001
    Material Weakness Repeat
  • 479256 2023-001
    Material Weakness Repeat
  • 479257 2023-001
    Material Weakness Repeat
  • 479258 2023-001
    Material Weakness Repeat
  • 479259 2023-001
    Material Weakness Repeat
  • 479260 2023-001
    Material Weakness Repeat
  • 479261 2023-001
    Material Weakness Repeat
  • 479262 2023-001
    Material Weakness Repeat
  • 479263 2023-001
    Material Weakness Repeat
  • 479264 2023-002
    Significant Deficiency Repeat
  • 479265 2023-002
    Significant Deficiency Repeat
  • 479266 2023-002
    Significant Deficiency Repeat
  • 479267 2023-002
    Significant Deficiency Repeat
  • 479268 2023-002
    Significant Deficiency Repeat
  • 479269 2023-002
    Significant Deficiency Repeat
  • 479270 2023-002
    Significant Deficiency Repeat
  • 479271 2023-002
    Significant Deficiency Repeat
  • 479272 2023-002
    Significant Deficiency Repeat
  • 479273 2023-002
    Significant Deficiency Repeat
  • 479274 2023-002
    Significant Deficiency Repeat
  • 479275 2023-002
    Significant Deficiency Repeat
  • 479276 2023-003
    Material Weakness
  • 479277 2023-003
    Material Weakness
  • 479278 2023-004
    Material Weakness Repeat
  • 479279 2023-005
    Material Weakness Repeat
  • 479280 2023-005
    Material Weakness Repeat
  • 479281 2023-005
    Material Weakness Repeat
  • 479282 2023-006
    Material Weakness Repeat
  • 479283 2023-006
    Material Weakness Repeat
  • 479284 2023-006
    Material Weakness Repeat
  • 479285 2023-006
    Material Weakness Repeat
  • 479286 2023-006
    Significant Deficiency Repeat
  • 479287 2023-006
    Significant Deficiency Repeat
  • 479288 2023-006
    Significant Deficiency Repeat
  • 479289 2023-006
    Significant Deficiency Repeat
  • 479290 2023-006
    Significant Deficiency Repeat
  • 479291 2023-006
    Significant Deficiency Repeat
  • 479292 2023-006
    Significant Deficiency Repeat
  • 479293 2023-006
    Significant Deficiency Repeat
  • 1055694 2023-001
    Material Weakness Repeat
  • 1055695 2023-001
    Material Weakness Repeat
  • 1055696 2023-001
    Material Weakness Repeat
  • 1055697 2023-001
    Material Weakness Repeat
  • 1055698 2023-001
    Material Weakness Repeat
  • 1055699 2023-001
    Material Weakness Repeat
  • 1055700 2023-001
    Material Weakness Repeat
  • 1055701 2023-001
    Material Weakness Repeat
  • 1055702 2023-001
    Material Weakness Repeat
  • 1055703 2023-001
    Material Weakness Repeat
  • 1055704 2023-001
    Material Weakness Repeat
  • 1055705 2023-001
    Material Weakness Repeat
  • 1055706 2023-002
    Significant Deficiency Repeat
  • 1055707 2023-002
    Significant Deficiency Repeat
  • 1055708 2023-002
    Significant Deficiency Repeat
  • 1055709 2023-002
    Significant Deficiency Repeat
  • 1055710 2023-002
    Significant Deficiency Repeat
  • 1055711 2023-002
    Significant Deficiency Repeat
  • 1055712 2023-002
    Significant Deficiency Repeat
  • 1055713 2023-002
    Significant Deficiency Repeat
  • 1055714 2023-002
    Significant Deficiency Repeat
  • 1055715 2023-002
    Significant Deficiency Repeat
  • 1055716 2023-002
    Significant Deficiency Repeat
  • 1055717 2023-002
    Significant Deficiency Repeat
  • 1055718 2023-003
    Material Weakness
  • 1055719 2023-003
    Material Weakness
  • 1055720 2023-004
    Material Weakness Repeat
  • 1055721 2023-005
    Material Weakness Repeat
  • 1055722 2023-005
    Material Weakness Repeat
  • 1055724 2023-006
    Material Weakness Repeat
  • 1055725 2023-006
    Material Weakness Repeat
  • 1055726 2023-006
    Material Weakness Repeat
  • 1055727 2023-006
    Material Weakness Repeat
  • 1055728 2023-006
    Significant Deficiency Repeat
  • 1055729 2023-006
    Significant Deficiency Repeat
  • 1055730 2023-006
    Significant Deficiency Repeat
  • 1055731 2023-006
    Significant Deficiency Repeat
  • 1055732 2023-006
    Significant Deficiency Repeat
  • 1055733 2023-006
    Significant Deficiency Repeat
  • 1055734 2023-006
    Significant Deficiency Repeat
  • 1055735 2023-006
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
93.778 Medical Assistance Program $3.83B
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $177.94M
93.767 Children's Health Insurance Program $143.99M
93.917 Hiv Care Formula Grants $28.34M
93.994 Maternal and Child Health Services Block Grant to the States $15.46M
93.268 Immunization Cooperative Agreements $7.73M
93.069 Public Health Emergency Preparedness $6.71M
10.558 Child and Adult Care Food Program $6.26M
93.940 Hiv Prevention Activities_health Department Based $6.24M
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $2.60M
93.889 National Bioterrorism Hospital Preparedness Program $2.50M
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $2.48M
93.991 Preventive Health and Health Services Block Grant $2.09M
93.977 Preventive Health Services_sexually Transmitted Diseases Control Grants $2.00M
84.181A Special Education-Grants for Infants and Families $1.88M
93.255 Children's Hospitals Graduate Medical Education Payment Program $1.39M
93.136 Injury Prevention and Control Research and State and Community Based Programs $1.20M
93.235 Affordable Care Act (aca) Abstinence Education Program $1.18M
93.777 State Survey and Certification of Health Care Providers and Suppliers (title Xviii) Medicare $958,075
84.181 Special Education-Grants for Infants and Families $948,583
93.377 Prevention and Control of Chronic Disease and Associated Risk Factors in the U.s. Affiliated Pacific Islands, U.s. Virgin Islands, and P. R. (b) $825,561
66.432 State Public Water System Supervision $706,328
93.944 Human Immunodeficiency Virus (hiv)/acquired Immunodeficiency Virus Syndrome (aids) Surveillance $667,263
66.468 Capitalization Grants for Drinking Water State Revolving Funds $646,811
93.092 Affordable Care Act (aca) Personal Responsibility Education Program $573,302
93.336 Behavioral Risk Factor Surveillance System $540,085
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $405,413
93.070 Environmental Public Health and Emergency Response $332,433
20.607 Alcohol Open Container Requirements $301,358
93.197 Childhood Lead Poisoning Prevention Projects_state and Local Childhood Lead Poisoning Prevention and Surveillance of Blood Lead Levels in Children $284,940
93.270 Adult Viral Hepatitis Prevention and Control $263,023
93.251 Early Hearing Detection and Intervention $262,404
93.130 Cooperative Agreements to States/territories for the Coordination and Development of Primary Care Offices $225,018
93.236 Grants to States to Support Oral Health Workforce Activities $206,120
93.048 Special Programs for the Aging_title Iv_and Title Ii_discretionary Projects $157,980
93.314 Early Hearing Detection and Intervention Information System (ehdi-Is) Surveillance Program $157,808
93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs $153,380
93.998 Autism and Other Developmental Disabilities, Surveillance, Research, and Prevention $115,166
93.387 National and State Tobacco Control Program (b) $74,316
14.241 Housing Opportunities for Persons with Aids $67,349
93.110 Maternal and Child Health Federal Consolidated Programs $59,893
93.967 Cdc's Collaboration with Academia to Strengthen Public Health $28,450
93.791 Money Follows the Person Rebalancing Demonstration $19,843
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health $18,871
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $12,384
93.008 Medical Reserve Corps Small Grant Program $11,960
93.497 Family Violence Prevention and Services/ Sexual Assault/rape Crisis Services and Supports $4,309
93.556 Promoting Safe and Stable Families $3,718
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $20
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $-168
93.074 Hospital Preparedness Program (hpp) and Public Health Emergency Preparedness (phep) Aligned Cooperative Agreements $-27,562