Finding Text
CASEFILE REVIEW (2024-005) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2405MN5ADM, 2405MN5MAP Federal Award Identification Number and Year: 2405MN5ADM, 2405MN5MAP, 2024 Compliance Requirement Affected: Eligibility Award Period: Year Ended December 31, 2024 Type of Finding: Material Weakness in Internal Control Over Compliance Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements and correctly determining program eligibility. Condition: There was no formal review documented over internal case files worked by program eligibility specialists. Questioned Costs: None Context: During our testing of eligibility and testing of case file reviews completed during 2024 for Medical Assistance, it was noted that there were no documented case file reviews performed. Cause: The Minnesota Department of Human Services is not requiring a review of case files and lack of staffing. 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 that the County review case files on a periodic basis throughout the year and document the review. Views of Responsible Officials: There is no disagreement with the audit finding.