Finding 1215512 (2025-003)

Material Weakness Repeat Finding
Requirement
E
Questioned Costs
-
Year
2025
Accepted
2026-05-26

AI Summary

  • Core Issue: Five out of 60 participant files lacked necessary documentation for medical services, indicating a systematic problem.
  • Impacted Requirements: Eligibility criteria as per Federal regulations (CFR Title 42) and Indian Health Services guidelines were not met.
  • Recommended Follow-Up: Implement annual file reviews, ensure independent oversight of documentation checks, and maintain records of these reviews for accountability.

Finding Text

Criteria: An individual must meet the eligibility requirements as defined by Federal regulations published in Code of Federal Regulations (CFR), at Title 42, Section 136.21 through 136.25, and Indian Health Services, Part 2, Chapter 3, “Contract Health Services” dated January 5, 1998. Condition: Of the 60 participant files reviewed, the following was noted: • 5 samples out of 60 did not have proper documentation to receive medical services and/or renewed registration application to receive medical services. Context: The audit findings represent a systematic problem, see condition above. Cause: There were ineffective controls in place during the period, along with lack of management oversight. Effect: By not ensuring proper reviews are occurring by a supervisor or other authorized individual, inaccurate information may have been entered into the online system, and ineligible participants could be receiving benefits. Questioned Costs: Not applicable. Repeat Finding: Yes, 2022-004, 2023-001, and 2024-001. Recommendation: We recommend that the Clinic adhere to program policies and procedures as documented and the files are reviewed annually for completeness, and that review of the online checklist is reviewed by someone other than the Patient Care Representative, and that this review is documented and maintained for review at a later date. Views of Responsible Officials: The Clinic will review all patient files to ensure all applicable documentation is located within each file. Any applicable documentation that is missing from the file will be requested from the patient to verify continued eligibility or services will be terminated. The Clinic will also implement an approval process for new patients to ensure patient eligibility is reviewed and approved prior to providing services.

Corrective Action Plan

The supervisor of registration employees will oversee quarterly patient file reviews of patients registered as beneficiaries to ensure that the required documentation is acquired from the patients. Patient files that lack the required documentation, will be flagged in a way that will be noticeable by anyone that has access to the files. The clinic will also consider an outside department like PRC which also validates beneficiary information could get involved in a mid-fiscal year review of the beneficiary patient files to provide a secondary review of the files. The anticipated completion date will be 9/30/2026.

Categories

Eligibility

Other Findings in this Audit

  • 1215511 2025-003
    Material Weakness Repeat
  • 1215513 2025-004
    Material Weakness Repeat
  • 1215514 2025-004
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.495 COMMUNITY HEALTH WORKERS FOR PUBLIC HEALTH RESPONSE AND RESILIENT $271,298
93.047 SPECIAL PROGRAMS FOR THE AGING, TITLE VI, PART A, GRANTS TO INDIAN TRIBES, PART B, GRANTS TO NATIVE HAWAIIANS $239,354
93.243 SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES PROJECTS OF REGIONAL AND NATIONAL SIGNIFICANCE $206,086
93.231 EPIDEMIOLOGY PROGRAM $169,616
93.441 INDIAN SELF-DETERMINATION $150,494
93.237 SPECIAL DIABETES PROGRAM FOR INDIANS DIABETES PREVENTION AND TREATMENT PROJECTS $96,890
93.558 TEMPORARY ASSISTANCE FOR NEEDY FAMILIES $84,566
93.054 NATIONAL FAMILY CAREGIVER SUPPORT, TITLE VI, PART C, GRANTS TO INDIAN TRIBES AND NATIVE HAWAIIANS $47,593
93.788 OPIOID STR $40,166
93.421 STRENGTHENING PUBLIC HEALTH SYSTEMS AND SERVICES THROUGH NATIONAL PARTNERSHIPS TO IMPROVE AND PROTECT THE NATION€™S HEALTH $37,743
93.053 NUTRITION SERVICES INCENTIVE PROGRAM $22,376