Finding 374351 (2022-005)

Significant Deficiency

Requirement

Questioned Costs

Year

2022

Accepted

2024-03-07

Audit: 293955

Organization: Maryland Emergency Medicine Network Inc. (MD)

Auditor: Rsm US LLP

AI Summary

Core Issue: The Company submitted their audit late, missing the deadline set by 45 CFR Part 75.
Impacted Requirements: Audits must be submitted within 30 days of receiving the auditor's report or nine months after the audit period ends.
Recommended Follow-Up: Management should establish procedures to ensure timely audit submissions in the future.

Finding Text

Criteria: Under 45 CFR Part 75, the Uniform Guidance requires that audits are submitted by the earlier of 30 calendar days after receipt of the auditor’s report or nine months after the end of the audit period. Condition: The Company did not complete and submit their audit to the federal clearinghouse until February 2024. Effect: The late filing could potentially impact future funding from government agencies. Cause: Significant delays stemming from Finding 2022-003 related to the Uninsured Program caused the required audit procedures and the ultimate completion date to extend beyond the defined deadlines. Recommendation: We recommend that management implement procedures and controls to ensure future audits are filed timely with the federal clearinghouse. Repeat finding: No Views of responsible officials and planned corrective actions: See attached letter. Reportable questioned costs: None

Corrective Action Plan

Significant delays resulted from Finding 2022-03 related to the Uninsured Program, causing the required audit procedures and the ultimate completion date to extend beyond defined deadlines. Actions: 1. Audit Efficiency Improvement: • Conduct a thorough review of audit processes to identify inefficiencies and implement measures to enhance efficiency. 2. Clear Communication with Auditors: • Establish clear communication channels with auditors to convey expectations, deadlines, and the importance of timely completion. • Regularly update auditors on any changes or developments that may impact the audit timeline. 3. Billing Company Data Timeliness: • Engage in proactive communication with the third-party billing company to emphasize the importance of providing data in a timely manner. • Implement contractual agreements specifying deadlines for data submission and consequences for delays. 4. Monitoring and Follow-Up: • Implement a monitoring system to track the progress of audit procedures and data submission from the third-party billing company. • Conduct regular follow-up with auditors and the third-party billing company to address any bottlenecks or delays promptly. Timeline: • Audit Efficiency Improvement: Implement immediately, February 2024 • Clear Communication with Auditors: Establish immediately, February 2024 • Billing Company Data Timeliness: Communicate deadlines to the third-party billing company within one month and enforce contractual agreements, March 2024 • Monitoring and Follow-Up: Begin monitoring system immediately and conduct regular follow-up, February 2024 Monitoring and Evaluation: • Regular progress meetings to track the implementation of corrective actions and monitor audit progress and data submission. • Assess the effectiveness of measures to improve auditor efficiency and ensure timely data submission through periodic reviews. • Solicit feedback from auditors and the third-party billing company to identify areas for improvement and adjustment. Contact: • Alain Viaud, aviaud@som.umaryland.edu, 667-214-2051

Other Findings in this Audit

374349 2022-004

Significant Deficiency
374350 2022-003

Material Weakness
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