Finding 1097074 (2024-001)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2024
Accepted
2025-01-29
Audit: 340308
Organization: Hyde County (NC)

AI Summary

  • Core Issue: There were inaccuracies in income and resource calculations for Medicaid eligibility, leading to potential mismanagement of benefits.
  • Impacted Requirements: Compliance with 42 CFR 435 and 2 CFR 200 was not met due to ineffective record-keeping and case review processes.
  • Recommended Follow-Up: Implement a corrective action plan to improve documentation and internal controls to ensure accurate eligibility determinations.

Finding Text

US Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medical Assistance Program AL #: 93.778 SIGNIFICANT DEFICIENCY Eligibility Criteria: Condition: Context: Section II - Financial Statement Findings Section I - Summary of Auditors' Results (continued) Section III - Federal Award Findings and Questioned Costs Finding: 2024-001 Inaccurate Information Entry In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a recipient meets specific income standards, and documentation must be maintained to support eligibility determinations. In accordance with 2 CFR 200, management should have an adequate system of internal controls procedures in place to ensure an applicant is properly determined or redetermined for benefits. There were 3 errors discovered during our procedures where income or household size was incorrectly calculated or inaccurate information was entered into the case file. There was no known affect to eligibility and there were no known questioned costs. We examined 60 cases from a total of 46,508 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. Questioned Cost: 151Effect: Identification of a repeat finding: Cause: US Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medical Assistance Program AL #: 93.778 Eligibility Criteria: Condition: Context: Effect: We examined 60 cases from a total of 46,508 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. Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Views of responsible officials: This is a repeat finding from the immediate previous audit 2023-007. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to North Carolina Families Accessing Services through Technology (NC FAST) and a participant could have been approved for benefits for which they were not eligible. The county agrees with the finding. Please refer to the corrective action plan for details. There was no known affect to eligibility and there were no known questioned costs. Inaccurate Resource Calculation Section III - Federal Award Findings and Questioned Costs (continued) Finding: 2024-002 SIGNIFICANT DEFICIENCY Questioned Costs: There were 1 errors discovered during our procedures where resources were imcorrectly calculated or were not properly documented in the case file. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to North Carolina Families Accessing Services through Technology (NC FAST) and a participant could have been approved for benefits for which they were not eligible. In accordance with Medicaid Manual MA-2230, Medicaid for Aged, Blind and Disabled case records should contain documentation that verifications were done in preparation of the application and these items will agree to reports in the NC FAST system. In this process, the countable resources should be calculated correctly and agree back to the amounts in the NC FAST system. Any items discovered in the verification process should be considered countable or noncountable resources and explained within the documentation.

Categories

Eligibility Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 520632 2024-001
    Significant Deficiency Repeat
  • 520633 2024-002
    Significant Deficiency Repeat
  • 520634 2024-003
    Significant Deficiency Repeat
  • 520635 2024-004
    Significant Deficiency
  • 1097075 2024-002
    Significant Deficiency Repeat
  • 1097076 2024-003
    Significant Deficiency Repeat
  • 1097077 2024-004
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
21.032 Local Assistance and Tribal Consistency Fund $998,758
14.228 Community Development Block Grants/state's Program and Non-Entitlement Grants in Hawaii $696,758
93.778 Medical Assistance Program $368,842
97.039 Hazard Mitigation Grant $266,913
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $144,354
93.658 Foster Care Title IV-E $91,327
21.027 Coronavirus State and Local Fiscal Recovery Funds $87,761
93.667 Social Services Block Grant $57,280
93.558 Temporary Assistance for Needy Families $46,368
93.069 Public Health Emergency Preparedness $41,960
93.045 Special Programs for the Aging, Title Iii, Part C, Nutrition Services $40,851
97.042 Emergency Management Performance Grants $39,698
93.991 Preventive Health and Health Services Block Grant $30,431
93.217 Family Planning Services $28,793
93.044 Special Programs for the Aging, Title Iii, Part B, Grants for Supportive Services and Senior Centers $28,453
93.994 Maternal and Child Health Services Block Grant to the States $27,506
20.106 Airport Improvement Program, Covid-19 Airports Programs, and Infrastructure Investment and Jobs Act Programs $19,225
93.568 Low-Income Home Energy Assistance $14,597
93.563 Child Support Services $12,457
20.513 Enhanced Mobility of Seniors and Individuals with Disabilities $8,044
93.268 Immunization Cooperative Agreements $7,767
93.053 Nutrition Services Incentive Program $5,537
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $3,040
93.556 Marylee Allen Promoting Safe and Stable Families Program $2,770
93.645 Stephanie Tubbs Jones Child Welfare Services Program $1,478
93.917 Hiv Care Formula Grants $520
93.566 Refugee and Entrant Assistance State/replacement Designee Administered Programs $101
93.977 Sexually Transmitted Diseases (std) Prevention and Control Grants $42
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $21