Finding Text
2023-001 Eligibility
Prior Year Finding Number: 2022-002
Year of Finding Origination: 2022
Type of Finding: Internal Control Over Compliance and Compliance
Severity of Deficiency: Material Weakness and Modified Opinion
Federal Agency: U.S. Department of Health and Human Services
Program: 93.778 Medical Assistance Program
Award Number and Year: 2305MN5ADM; 2023
Pass-Through Agency: Minnesota Department of Human Services
Criteria: Title 2 U.S. Code of Federal Regulations § 200.303 states that the auditee must establish and maintain effective internal control over the federal award that provides reasonable assurance that the auditee is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award.
Condition: The Minnesota Department of Human Services maintains the computer system, MAXIS, which is used by Sibley County to support the eligibility determination process. In the case files reviewed for eligibility, not all documentation to support participant eligibility was input into MAXIS. The following exceptions were noted in the sample of 40 MAXIS case files tested:
• four case files which contained citizenship verification but citizenship in MAXIS was noted as not verified.
• three case files where the asset or income listed in MAXIS did not match the documentation in the case file.
Questioned Costs: None.
Context: The State of Minnesota and the County split the eligibility determination process. Pursuant to Minnesota statutes, Sibley County performs the “intake function” needed for this program, while the state maintains the MAXIS system, which supports the eligibility determination process. Participants receive benefit payments from the state.
The sample size was based on guidance from Chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits.
Effect: The lack of updated information in MAXIS to document verification of key eligibility-determining factors increases the risk that program participants will receive benefits when they are not eligible.
Cause: Program personnel entering case data into MAXIS reviewed the support but did not enter or update the information in the system.
Recommendation: We recommend Sibley County implement additional procedures to provide reasonable assurance that the information is properly input or updated in MAXIS.
View of Responsible Official: Acknowledge.