Finding Text
CONTROLS OVER ELIGIBILITY (2024-003) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2405MN5ADM and 2405MN5MAP, 2024 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2405MN5ADM and 2405MN5MAP Award Period: Year-Ended December 31, 2024 Type of Finding: Significant Deficiency in Internal Control over Compliance Criteria or Specific Requirement: Standard internal control procedures suggest that casefile eligibility determination should have a timely review documented by someone other than the preparer. Condition: During testing of controls over eligibility, it was noted the County did not have adequate internal controls designed to ensure that casefiles were reviewed for correct eligibility determination. Questioned Costs: None. Context: During testing of controls over eligibility casefile reviews, it was noted that there were no reviews for Non-MAGI cases and MAGI cases. Cause: Lack of management oversight. Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: Yes, 2023-005 Recommendation: We recommend the County increase review over casefiles and ensure that there are performed on a periodic basis throughout the year. Views of Responsible Officials: There is no disagreement with the audit finding.