Finding Text
Hertford 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 Dept. of Health and Human Services
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL# 93.778
Finding: 2024-008 Inaccurate Resources Entry
SIGNIFICANT DEFICENCY
Eligibility
Criteria:
Condition:
Questioned Costs:
Context:
Effect:
Identification of a
repeat finding:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
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.
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 of 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.
The County agrees with the finding. See the response in the corrective action plan.
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 non-countable resources and explained within the documentation.
There was 1 error discovered during our procedures where resources were imcorrectly calculated or
were not properly documented in the case file.
There was no known affect to eligibility and there were no known questioned costs.
We examined 60 cases from of a total of 353,314 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, 2023-009.
Section III. Federal Award Findings and Questioned Costs (continued)
118