Finding 1135596 (2021-009)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2021
Accepted
2025-05-02
Audit: 355385
Organization: Caswell County (NC)

AI Summary

  • Core Issue: Repeat finding of non-cooperation with Child Support Enforcement affecting Medicaid eligibility determination.
  • Impacted Requirements: Compliance with Medicaid Manual MA-3365 regarding case evaluations and referrals to Child Support Agencies.
  • Recommended Follow-Up: Implement internal reviews to ensure accurate documentation and adherence to eligibility procedures.

Finding Text

CASWELL COUNTY, NORTH CAROLINA Schedule of Findings and Questioned Costs For the Year Ended June 30, 2021 Views of responsible officials: 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) CFDA# 93.778 Finding 2021-009 IV-D Non-Cooperation SIGNIFICANT DEFICIENCY Eligibility Criteria: Condition: Questioned Costs: Context: Effect: Identification of a repeat finding: Cause: Recommendation: Views of Responsible officials and corrective action plans: Section III. Federal Award Findings and Questioned Costs (continued) The county agrees with the finding. Please refer to the corrective action plan for details. This is a repeat finding from the immediate previous audit, 2020-005 Human error in reading the Automated Collection and Tracking System (ACTS) report and/or ineffective case review process. 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 that clearly indicates what actions were performed and the results of those actions. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to North Carolina Families Accessing Services through Technology (NC FAST) and a participant could have been approved for benefits for which they were not eligible. 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. There was 3 errors discovered during our procedures that referrals between DSS and Child Support Agencies were not properly made. There was no known affect to eligibility and there were no known questioned costs. We examined 60 cases 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. The County agrees with this finding. Please refer to the corrective action plan for details. 118

Categories

Eligibility Significant Deficiency

Other Findings in this Audit

  • 559154 2021-009
    Significant Deficiency Repeat
  • 559155 2021-010
    Significant Deficiency Repeat
  • 559156 2021-011
    Significant Deficiency
  • 559157 2021-012
    Significant Deficiency
  • 1135597 2021-010
    Significant Deficiency Repeat
  • 1135598 2021-011
    Significant Deficiency
  • 1135599 2021-012
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
14.871 Section 8 Housing Choice Vouchers $1.15M
21.019 Coronavirus Relief Fund $834,253
93.778 Medical Assistance Program $623,744
93.558 Temporary Assistance for Needy Families $338,690
93.563 Child Support Services $318,086
93.568 Low-Income Home Energy Assistance $312,590
20.509 Formula Grants for Rural Areas and Tribal Transit Program $296,698
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $238,434
93.045 Special Programs for the Aging, Title Iii, Part C, Nutrition Services $185,952
93.667 Social Services Block Grant $177,648
93.658 Foster Care Title IV-E $149,070
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $130,088
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $116,706
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $80,237
93.268 Immunization Cooperative Agreements $75,769
93.217 Family Planning Services $32,078
16.575 Crime Victim Assistance $31,014
93.069 Public Health Emergency Preparedness $30,720
93.991 Preventive Health and Health Services Block Grant $26,240
93.053 Nutrition Services Incentive Program $24,148
93.994 Maternal and Child Health Services Block Grant to the States $22,637
93.000 Foster Care $17,542
93.052 National Family Caregiver Support, Title Iii, Part E $16,662
93.044 Special Programs for the Aging, Title Iii, Part B, Grants for Supportive Services and Senior Centers $10,878
93.645 Stephanie Tubbs Jones Child Welfare Services Program $8,582
93.767 Children's Health Insurance Program $8,317
93.556 Marylee Allen Promoting Safe and Stable Families Program $8,232
93.110 Maternal and Child Health Federal Consolidated Programs $7,500
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $4,718
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $4,505
93.659 Adoption Assistance $818
93.977 Sexually Transmitted Diseases (std) Prevention and Control Grants $100
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $50