Finding 1100720 (2024-003)

Johnston County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2024 Finding: 2024-003 Inadequate Request for Information SIGNIFICANT DEFICIENCY Eligibility Criteria: Condition: Questioned Costs: Context: Effect: Identification of a repeat finding: Cause: Recommendation: Views of responsible officials and planned corrective actions: US Department of Health and Human Services Section III. Federal Award Findings and Questioned Costs (continued) Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. 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. AL # 93.778 This is a repeat finding from the immediate previous audit, 2023-003. Passed through the NC Dept. of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) 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. Electronic matches are required at applications and redeterminations. The County agrees with the finding. See Corrective Action Plan in the following section. There were 8 errors discovered during our procedures that inadequate information was requested at applications and/or redeterminations. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which could affect countable resource. Therefore, applicants could have received assistance for which they were not eligible. 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. There was no known affect to eligibility and there were no known questioned costs. 231