Finding 374349 (2022-004)

Significant Deficiency
Requirement
L
Questioned Costs
-
Year
2022
Accepted
2024-03-07
Audit: 293955
Auditor: Rsm US LLP

AI Summary

  • Core Issue: The calculation of lost revenues for 2021 was inaccurate, failing to match audited net patient revenue figures.
  • Impacted Requirements: Reporting through the Required Relief Funds Reporting Portal must accurately reflect expenses and lost revenues.
  • Recommended Follow-Up: Implement procedures for accurate reporting and ensure a secondary review by management before submissions.

Finding Text

Criteria: The Provider Relief Funds are required to be reported through the Required Relief Funds Reporting Portal and include key items for Provider Relief Fund expenses and calculation of lost revenues. Condition: While management’s calculation of lost revenues for 2020 was determined to be accurate, as the 2019 and 2020 reported numbers in the portal submission reconciled and agreed to the Company’s audited net revenue amounts for those periods, the calculation of lost revenues for 2021 was not accurate. The reported amounts of net revenue from fiscal year 2021 and fiscal year 2022 (partially from calendar year 2021) did not reconcile or agree to the audited amounts of net patient revenue from these periods. Effect: The reporting in the portal inaccurately reported total lost revenues for each subsidiary’s portal submission. However, there were no questioned costs, as the 2020 reported lost revenues that were determined to be accurate, exceeded any amounts received from the Provider Relief Fund in the period under audit, and the cumulative receipts of Provider Relief Funding in all periods. Cause: The Company’s reporting over patient service revenue that was utilized in the compilation of the portal submission was inaccurate, and did not agree to the final 2021 audited amounts. In addition, there was no evidence that a secondary member of management reviewed the information prior to its submission. Recommendation: We recommend that management implement procedures and controls to ensure that all reporting and submissions to federal agencies are accurate and are sufficiently reviewed by another member of management prior to the submission. Repeat finding: No Views of responsible officials and planned corrective actions: See attached letter. Reportable questioned costs: None

Corrective Action Plan

While management’s calculation of lost revenues for 2020 was determined to be accurate, as the 2019 and 2020 reported numbers in the portal submission reconciled and agreed to MEMN’s audited net revenue amounts for those periods, the calculation of lost revenues for 2021 was not accurate. The reported amounts of net revenue from fiscal year 2021 and fiscal year 2022 (partially from calendar year 2021) did not reconcile or agree to the audited amounts of net patient revenue from these periods. Actions: 1. Establish Reporting Review Procedures: • Develop a formal procedure for reviewing all reports and submissions to federal agencies before submission. • Designate a responsible party within management to oversee the review process and ensure compliance with established procedures. 2. Documentation and Record-Keeping: • Implement a documentation system to track the review process for each report or submission. 3. Dual Review Requirement: • Ensure that all reports and submissions to federal agencies undergo a dual review process, when possible. • While we understand the importance of accuracy and compliance in our reporting processes, instituting a dual review requirement may not be feasible for MEMN given our size and resource constraints. As a small company, we operate with limited staff and resources, and imposing a dual review requirement could impose unnecessary burdens on our team members and hinder efficiency. Instead, we will explore alternative measures to ensure the accuracy of our reports and submissions. This includes implementing robust internal controls, enhancing documentation procedures, and providing guidance to staff involved in the reporting process. By strengthening our internal processes and promoting a culture of accountability and mindfulness, we can mitigate the risk of errors and discrepancies without imposing additional layers of review. Additionally, a more practical approach would be to designate a single individual within our organization to oversee the review process. This individual would be responsible for conducting a thorough review of each report or submission before it is finalized and submitted. This approach maintains accountability while avoiding the logistical challenges associated with implementing a dual review requirement. 4. Enhanced Reconciliation Procedures: • Improve reconciliation procedures between reported amounts and audited financial data. • Conduct regular reconciliations between reported net revenue figures and audited net patient revenue amounts to identify discrepancies promptly. 5. Internal Controls Enhancement: • Strengthen internal controls related to financial reporting and submissions to federal agencies. Timeline: • Establish Reporting Review Procedures and Documentation: Complete within three months, May 2024 • Review Requirement: Implement immediately, February 2024 • Enhanced Reconciliation Procedures: Begin within three months, May 2024 • Internal Controls Enhancement: Implement within four months, June 2024 Monitoring and Evaluation: • Regular progress meetings to track the implementation of corrective actions. • Monitor the effectiveness of the dual review process and reconciliation procedures through periodic assessments. • Conduct internal audits to evaluate compliance with established procedures and identify areas for improvement. Contact: • Alain Viaud, aviaud@som.umaryland.edu, 667-214-2051

Categories

Reporting

Other Findings in this Audit

  • 374350 2022-003
    Material Weakness
  • 374351 2022-005
    Significant Deficiency
  • 950791 2022-004
    Significant Deficiency
  • 950792 2022-003
    Material Weakness
  • 950793 2022-005
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $1.07M
93.461 Covid-19 Testing for the Uninsured $252,762