Finding 371189 (2023-002)

US Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medicaid Assistance Program (Medicaid; Title XIX) AL # 93.778 Finding: 2023-002 IV-D Cooperation with Child Support SIGNIFICANT DEFICENCY Eligibility Criteria: Section III - Federal Award Findings and Questioned Costs The County's management and other users of the financial statements do not have accurate information for decisions-making and monitoring of the county's financial position and adherence to laws, regulations, and other requirements. Errors in financial reporting could occur and not be detected. County records were not reconciled properly. The County should review the ledger and financial documents regularly to ensure that necessary adjustments are made timely during the year. If information is required from outside parties, be sure to request this information in time to make an necessary adjustments. The County agrees with this finding. Please refer to the corrective action plan for details. Section II - Financial Statement Findings Management should have a system in place to verify that transactions are recorded in correctly, thereby reducing the likelihood of errors in financial reporting. Prior period adjustments were made to the General Fund that decreased fund balance by $13,188. These adjustment were to record a correction to forfeiture funds that were received which had been deposited into the Forfeiture - Treasury checking account, which should have been deposited into the Forfeiture - Department of Justice account. In accordance with the Medicaid Manual MA-3365, all Medicaid cases should be evaluated and referred to the Child Support Enforcement Agency (IV-D). The Child Support Enforcement Agency (IV-D) can assist the family in obtaining financial and/or medical support or medical support payments from the child’s non-custodial parent. Cooperation requirement with Social Services and Child Support Agencies must be met or good cause for not cooperating must be established when determining Medicaid eligibility. Condition: Questioned Cost: Context: Effect: Identification of a repeat finding: Cause: Recommendation: Views of responsible officials and planned corrective actions: US Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medicaid Assistance Program (Medicaid; Title XIX) AL # 93.778 Finding: 2023-003 Inaccurate Resources Entry SIGNIFICANT DEFICENCY Eligibility Criteria: Section III - Federal Award Findings and Questioned Costs (Continued) The County agrees with the finding. In accordance with Medicaid Manual MA-2230, Medicaid for Aged, Blind and Disabled case records should contain documentation that verifications were done in preparation of the application and these items will agree to reports in the NC FAST system. In this process, the countable resources should be calculated correctly and agree back to the amounts in the NC FAST system. Any items discovered in the verification process should be considered countable or noncountable resources and explained within the documentation. There were 6 errors discovered during our procedures that referrals between the County's Department of Social Services and Child Support Agencies were not properly made. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to North Carolina Families Accessing Services through Technology (NC FAST) and a participant could have been approved for benefits for which they were not eligible. Human error in reading the Automated Collection and Tracking System (ACTS) report and/or ineffective case review process. This is a repeat finding from the immediate previous audit, 2022-004. Files should be reviewed internally to ensure proper information is in place and necessary procedures are taken when determine eligibility. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. There was no known affect to eligibility and there were no known questioned costs. We examined 60 cases from of a total of 552,116 Medicaid claims from the Medicaid beneficiary report provided by NC Department of Health and Human Services to redetermine eligibility. These findings are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit.