Finding 1100718 (2024-001)

Johnston County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2024 Identification of major State programs: Program Name Medical Assistance Program State Foster Home Fund (SFHF) Maximization Connect NC Bond Johnston County Radio and Paging Infrastructure Upgrade Public School Building Capital Fund-Lottery Proceeds Dollar threshold used to determine State major programs $ 500,000 Auditee qualified as low-risk auditee? yes X no None Reported. Finding: 2024-001 Inaccurate Information Entry SIGNIFICANT DEFICIENCY Eligibility Criteria: Condition: Questioned Costs: Context: Effect: Identification of a repeat finding: Cause: There was no known affect to eligibility and there were no known questioned costs. We examined 60 cases from of a total of 2,229,628 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. This is a repeat finding from the immediate previous audit, 2023-002. Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST and a participant could have been approved for benefits for which they were not eligible. US Department of Health and Human Services Section I. Summary of Auditors' Results (continued) Section II. Financial Statement Findings Section III. Federal Award Findings and Questioned Costs Passed through the NC Dept. of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) AL # 93.778 In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a recipient meets specific 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 that inaccurate information was entered when determining eligibility. 229