Finding 1238523 (2025-003)

2025-003 – Eligibility for Purchased/Refer\red Care (PRC) Finding Type. Immaterial Noncompliance (Eligibility)/Significant Deficiency in Internal Control over Compliance Program. Tribal Self-Governance and Determination Cluster; U.S. Department of Health & Human Services; Assistance Listing Number 93.210 and 93.441; All Awards Criteria. Recipients of federal awards are required to follow their own internal policies, as well as comply with standards set forth in the Uniform Guidance. Part of that guidance requires tribes and tribal organizations that receive funds under this program to make the required determination (including obtaining and retaining any required documentation/verifications) that the individual was eligible to receive services in accordance with the compliance requirements of the program. Condition. During our audit, we noted for one of forty health service selections, the Tribe was unable to provide the vendor invoice and check for a PRC service to support the amount paid and type of service the patient received. However, the Tribe was able to provide support for who the service was for and support that the particular individual was in fact eligible to receive such service under this grant program. Cause. This condition was caused by management not appropriately retaining the required documentation. Effect. As a result of this condition, the Tribe did not fully comply with the requirements of the Uniform Guidance and is exposed to an increased risk that future noncompliance could occur and not be prevented or detected by the Tribe's internal controls. Questioned Costs. Questioned costs identified were less than the threshold for reporting of unallowable costs Recommendation. We recommend that the Tribe implement necessary internal controls to ensure documentation of its compliance with the requirements of the Uniform Guidance is maintained. View of Responsible Officials. Management concurs with this finding. Due to HIPPA Laws, accounting is creating a form to send to the Clinic with each AP check run for them to complete indicating that they have attached all documents to the check stub and filed in the correct client’s folder as well as indicating that the client is a member, or descendent. This report will be returned within 24 business hours to the accounting department for auditing records.