Finding 1097077 (2024-004)

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

AI Summary

  • Core Issue: Inadequate record keeping and case review processes led to incomplete documentation for Medicaid eligibility.
  • Impacted Requirements: Compliance with Medicaid Manual MA-3365 regarding referrals to Child Support Enforcement and proper documentation of eligibility criteria.
  • Recommended Follow-Up: Conduct internal reviews of files, retrain staff on documentation standards, and ensure all case notes clearly reflect actions taken and their outcomes.

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 Eligibility Criteria: Condition: Context: Recommendation: Files should be reviewed internally to ensure proper documentation is in place for eligibility. Workers should be retrained on what files should contain and the importance of complete and accurate record keeping. We recommend that all files include online verifications, documented resources and income and those amounts agree to information in NC FAST. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. Views of responsible officials: The county agrees with the finding. Please refer to the corrective action plan for details. Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Finding: 2024-004 Non-Cooperation With Child Support Procedures SIGNIFICANT DEFICIENCY In accordance with the Medicaid Manual MA-3365, all Medicaid cases should be evaluated and referred to the Child Support Enforcement Agency (IV-D). The Child Support Enforcement Agency (IV-D) can assist the family in obtaining financial and/or medical support or medical support payments from the child’s non-custodial parent. Cooperation requirement with Social Services and Child Support Agencies must be met or good cause for not cooperating must be established when determining Medicaid eligibility. There were 1 errors discovered during our procedures that referrals between DSS and Child Support Agencies were not properly made. Questioned Costs: 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.Effect: Cause: U.S. Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medical Assistance Program AL #: 93.778 Views of responsible officials: The county agrees with the finding. Please refer to the corrective action plan for details. Section III - Federal Award Findings and Questioned Costs (continued) Human error in reading the Automated Collection and Tracking System (ACTS) report and/or ineffective case review process. Recommendation: Files should be reviewed internally to ensure proper information is in place and necessary procedures are taken when determining eligibility. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. SIGNIFICANT DEFICENCY: Finding 2024-001, 2024-002, 2024-003, 2024-004 also apply to State requirements and State Awards. Section IV - State Award Findings and Questioned Costs For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST and applicants could have been approved for benefits for which they were not eligible.

Categories

Eligibility Significant Deficiency

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
  • 1097074 2024-001
    Significant Deficiency Repeat
  • 1097075 2024-002
    Significant Deficiency Repeat
  • 1097076 2024-003
    Significant Deficiency Repeat

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