Finding 1150182 (2023-013)

CASWELL COUNTY, NORTH CAROLINA Schedule of Findings and Questioned Costs For the Year Ended June 30, 2023 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: 2023-013 IV-D Non-Cooperation SIGNIFICANT DEFICIENCY Eligibility Criteria: Condition: Questioned Costs: Context: Effect: Identification of a repeat finding: Cause: Recommendation: 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 were 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 of a total of 229,178 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. 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. Section III. Federal Award Findings and Questioned Costs (continued) This is a repeat finding from the immediate previous audit, 2022-012 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. 126