Finding 1095696 (2022-002)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2022
Accepted
2025-01-14
Audit: 337911
Organization: Wakemed (NC)

AI Summary

  • Core Issue: WakeMed improperly charged costs for ineligible individuals to the COVID-19 reimbursement grant.
  • Impacted Requirements: Compliance with eligibility criteria for the COVID-19 Claims Reimbursement program, specifically regarding insurance coverage.
  • Recommended Follow-Up: Implement a process to regularly review patient insurance status to ensure ongoing eligibility and prevent future errors.

Finding Text

Assistance Listing Number, Federal Agency, and Program Name - 93.461, Department of Health and Human Services, COVID-19 Claims Reimbursement for the Uninsured Program and the COVID-19 Coverage Assistance Fund Federal Award Identification Number and Year - N/A Pass through Entity - N/A Finding Type - Significant deficiency Repeat Finding - Yes Prior year finding number: 2021-001 Criteria - The COVID-19 Claims Reimbursement for the Uninsured Program and the COVID-19 Coverage Assistance Fund grant is to be used for "reimbursement of payment for COVID-19 testing and testing related items for individuals who do not have coverage through an individual or employer sponsored plan," per the 2022 Compliance Supplement. Condition - WakeMed charged costs associated with ineligible individuals to the grant. Questioned Costs - None Identification of How Questioned Costs Were Computed - N/A Context - During testing of 60 patients, we identified 1 patient who should not have been submitted to HRSA for reimbursement, as they were covered by insurance and, therefore, ineligible. The ineligible cost was removed from the SEFA and is in the process of being refunded to HRSA. Cause and Effect - While WakeMed had a process in place to review individuals for eligibility prior to claims being submitted, there was no process to subsequently evaluate changes in insurance status that may result in the patient being ineligible for the program. Recommendation - WakeMed should have a process in place to review and identify claims in which insurance status may have changed, in which refunds need to be issued to HRSA. Views of Responsible Officials and Corrective Action Plan - Management agrees with the finding as reported. WakeMed identified all HRSA patients with other documented insurance within the system. Each claim was reviewed to identify patients with active insurance coverage. Patients identified with active insurance coverage were considered ineligible for grant purposes, and the HRSA payments are in the process of being refunded. These costs were removed from the SEFA. In addition, WakeMed has written off all outstanding HRSA claims.

Categories

Eligibility Cash Management Reporting Significant Deficiency

Other Findings in this Audit

  • 519253 2022-001
    Significant Deficiency
  • 519254 2022-002
    Significant Deficiency Repeat
  • 519255 2022-003
    Material Weakness
  • 519256 2022-004
    Material Weakness
  • 1095695 2022-001
    Significant Deficiency
  • 1095697 2022-003
    Material Weakness
  • 1095698 2022-004
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Covid-19 - Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $10.90M
93.461 Covid-19 - Hrsa Covid-19 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $3.36M
21.027 Covid-19 - Coronavirus State and Local Fiscal Recovery Funds $1.01M
14.218 Community Development Block Grants/entitlement Grants $190,937
93.107 Area Health Education Centers $151,063