Finding 1095343 (2024-003)

U.S. Department of Health and Human Services Passed-through the N.C. Department of Health and Human Services Program Name: Medicaid Cluster AL # 93.778 Grant Number: 071-420 Finding: 2024-003 Significant Deficiency, Eligibility Nonmaterial Non-compliance Criteria: In accordance with 2 CFR 200, management should have an adequate system of internal control procedures in place to ensure that casefiles include all required documentation. In accordance with 45 CFR 435, documentation must be maintained to support eligibility determinations. Condition: The County Department of Social Services maintained inconsistent documentation for income and household membership. Context: Of the 484,970 benefit payments valued at $183,928,254, we examined 60 ($24,334 value) and determined that one casefile (2%) had inconsistent documentation supporting the eligibility determination in the case file. Upon further review, the recipient was deemed eligible. Effect: Casefile maintained inconsistent documentation, which could allow benefits to be provided to individuals who are not eligible. Cause: The caseworker did not verify updated documentation to the NCFAST system. Questioned Costs: None. The finding represents an internal control issue; therefore, no questioned costs are applicable. The County was able to substantiate that the recipients were eligible to receive benefits. Recommendation: Caseworkers should review their eligibility determinations and ensure that the correct information is included for proper documentation for eligibility. Views of Responsible Officials and Planned Corrective Actions: The County agrees with this finding. Please refer to the Corrective Action Plan section of this report