Finding 1100759 (2024-008)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2024
Accepted
2025-02-24
Audit: 343516
Organization: Northampton County (NC)

AI Summary

  • Core Issue: Medicaid eligibility assessments are not consistently referred to the Child Support Enforcement Agency, risking improper benefit approvals.
  • Impacted Requirements: Compliance with Medicaid Manual MA-3365, which mandates cooperation with Child Support Agencies for eligibility determinations.
  • Recommended Follow-Up: Conduct internal reviews of case files to ensure accurate documentation and adherence to eligibility procedures, addressing the repeat finding from the previous audit.

Finding Text

Northampton County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2024 US Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medicaid Assistance Program (Medicaid; Title XIX) AL# 93.778 Finding 2024-008 IV-D Cooperation with Child Support SIGNIFICANT DEFICIENCY Eligibility Criteria: 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 determine Medicaid eligibility. Context: We examined 60 cases from of a total of 262,448 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 Costs: There was no known affect to eligibility and there were no known questioned costs. Section III – Federal Award Findings and Questioned Costs Effect: 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. Cause: Human error in reading the 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 determine eligibility. 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 and planned corrective actions: The County agrees with the finding. See Corrective Action Plan. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2023-008. Condition: There was 1 error discovered during our procedures that referrals between DSS and Child Support Agencies were not properly made. 142

Categories

Eligibility Significant Deficiency

Other Findings in this Audit

  • 524317 2024-008
    Significant Deficiency Repeat
  • 524318 2024-009
    Significant Deficiency Repeat
  • 524319 2024-010
    Significant Deficiency Repeat
  • 524320 2024-011
    Significant Deficiency Repeat
  • 1100760 2024-009
    Significant Deficiency Repeat
  • 1100761 2024-010
    Significant Deficiency Repeat
  • 1100762 2024-011
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
21.027 Coronavirus State and Local Fiscal Recovery Funds $1.54M
93.778 Medical Assistance Program $1.33M
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $516,124
93.558 Temporary Assistance for Needy Families $481,718
93.563 Child Support Services $466,070
14.251 Economic Development Initiative, Community Project Funding, and Miscellaneous Grants $393,228
93.667 Social Services Block Grant $259,238
93.658 Foster Care Title IV-E $116,913
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $116,901
93.967 Centers for Disease Control and Prevention Collaboration with Academia to Strengthen Public Health $85,219
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $83,380
93.767 Children's Health Insurance Program $77,364
93.994 Maternal and Child Health Services Block Grant to the States $63,622
93.268 Immunization Cooperative Agreements $61,120
93.940 Hiv Prevention Activities Health Department Based $58,587
93.568 Low-Income Home Energy Assistance $56,182
93.045 Special Programs for the Aging, Title Iii, Part C, Nutrition Services $44,701
93.217 Family Planning Services $39,648
93.069 Public Health Emergency Preparedness $32,049
93.991 Preventive Health and Health Services Block Grant $30,431
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $21,337
93.044 Special Programs for the Aging, Title Iii, Part B, Grants for Supportive Services and Senior Centers $17,379
93.053 Nutrition Services Incentive Program $7,554
93.110 Maternal and Child Health Federal Consolidated Programs $2,000
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $1,253
93.659 Adoption Assistance $848
93.917 Hiv Care Formula Grants $337
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $50