Finding 1221287 (2025-004)

Material Weakness Repeat Finding
Requirement
E
Questioned Costs
-
Year
2025
Accepted
2026-06-30
Audit: 405646
Organization: Mower County (MN)

AI Summary

  • Core Issue: The County lacks adequate procedures to verify eligibility for Medicaid, leading to potential errors in determining client eligibility.
  • Impacted Requirements: Compliance with Uniform Guidance is not met, specifically regarding documentation for income, citizenship, and social security numbers.
  • Recommended Follow-Up: Implement procedures to ensure all required documentation is retained and matches the METS eligibility system, along with staff training on proper documentation practices.

Finding Text

Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Grants to States for Medicaid (Medicaid Cluster) Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services Federal Award Identification and Pass-Through Numbers: 2505MN5ADM and 2505MN5MAP Award Period: Year Ended December 31, 2025 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matter Criteria or Specific Requirement: Uniform Guidance requires the County to ensure compliance over eligibility by having the proper documentation of income, citizenship, redeterminations, and social security numbers. Condition: During our testing of compliance over eligibility, it was noted the County did not have adequate procedures designed to ensure the verifications required were properly obtained. Context: During testing, it was noted that 1 of 60 Medical Assistance case files tested did not have proper documentation to support citizenship verification. The sample sizes were based on guidance from chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits. Questioned Costs: None noted. Cause: 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: No. Recommendation: We recommend the County implement procedures to ensure that asset and income documentation in the casefiles be retained and that it matches the information input into the METS eligibility system. Views of responsible officials: There is no disagreement with the audit finding. There is an effort to maintain a strong healthcare processing leadership team. In addition, training will be provided to health and human services staff regarding proper documentation and entry into METS and staff will be reminded to perform reviews.

Corrective Action Plan

Eligibility Determination Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Grants to States for Medicaid (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Numbers and Year: 2505MN5MAP and 2505MN5ADM, 2025 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2505MN5MAP and 2505MN5ADM Compliance Requirement Affected: Eligibility Award Period: Year-Ended December 31, 2025 Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matters Recommendation: It is recommended the County implement procedures to ensure the citizenship, asset, and income verification documentation in the casefiles be retained and that it matches the METS eligibility system. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The County will review procedures and show staff proper documentation and entry into METS and staff will be reminded to perform reviews. Name of the contact person responsible for corrective action plan: Loni Swenson, Finance Director Planned completion date for corrective action plan: December 31, 2026

Categories

Internal Control / Segregation of Duties Eligibility Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.778 GRANTS TO STATES FOR MEDICAID $1.86M
93.558 TEMPORARY ASSISTANCE FOR NEEDY FAMILIES $683,635
10.557 WIC SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS, AND CHILDREN $359,182
93.667 SOCIAL SERVICES BLOCK GRANT $233,071
97.036 DISASTER GRANTS - PUBLIC ASSISTANCE (PRESIDENTIALLY DECLARED DISASTERS) $223,727
10.561 STATE ADMINISTRATIVE MATCHING GRANTS FOR THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM $144,156
93.967 CENTERS FOR DISEASE CONTROL AND PREVENTION COLLABORATION WITH ACADEMIA TO STRENGTHEN PUBLIC HEALTH $132,332
93.658 FOSTER CARE TITLE IV-E $115,868
93.323 EPIDEMIOLOGY AND LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC) $75,257
20.608 MINIMUM PENALTIES FOR REPEAT OFFENDERS FOR DRIVING WHILE INTOXICATED $75,141
97.042 EMERGENCY MANAGEMENT PERFORMANCE GRANTS $56,244
93.563 CHILD SUPPORT SERVICES $51,436
93.994 MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT TO THE STATES $51,051
20.600 STATE AND COMMUNITY HIGHWAY SAFETY $44,952
93.069 PUBLIC HEALTH EMERGENCY PREPAREDNESS $34,426
93.575 CHILD CARE AND DEVELOPMENT BLOCK GRANT $19,849
93.590 COMMUNITY-BASED CHILD ABUSE PREVENTION GRANTS $17,533
93.268 IMMUNIZATION COOPERATIVE AGREEMENTS $15,463
93.556 MARYLEE ALLEN PROMOTING SAFE AND STABLE FAMILIES PROGRAM $7,285
93.472 TITLE IV-E PREVENTION PROGRAM $5,904
20.205 HIGHWAY PLANNING AND CONSTRUCTION $5,724
93.566 REFUGEE AND ENTRANT ASSISTANCE STATE/REPLACEMENT DESIGNEE ADMINISTERED PROGRAMS $3,447
93.645 STEPHANIE TUBBS JONES CHILD WELFARE SERVICES PROGRAM $3,434
10.578 WIC GRANTS TO STATES (WGS) $1,061
93.757 STATE AND LOCAL PUBLIC HEALTH ACTIONS TO PREVENT OBESITY, DIABETES, HEART DISEASE AND STROKE (PPHF) $316
93.251 EARLY HEARING DETECTION AND INTERVENTION $225
93.674 JOHN H. CHAFEE FOSTER CARE PROGRAM FOR SUCCESSFUL TRANSITION TO ADULTHOOD $166