Finding Text
2022-004 Eligibility
Prior Year Finding Number: N/A
Repeat Finding Since: N/A
Type of Finding: Internal Control Over Compliance and Compliance
Severity of Deficiency: Significant Deficiency and Other Matter
Federal Agency: U.S. Department of Health and Human Services
Program: 93.778 Medical Assistance Program
Award Number and Year: 2205MN5ADM; 2022
Pass-Through Agency: Minnesota Department of Human Services
Criteria: Title 2 U.S. Code of Federal Regulations § 200.303 states that the auditee must establish and maintain effective internal control over the federal award that provides reasonable assurance that the auditee is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award.
Condition: The Minnesota Department of Human Services maintains the computer systems, MAXIS and METS, which are used by the Western Prairie Human Services to support the eligibility determination process. The following exceptions were noted in the samples of 40 case files tested for each system:
• Three case files had asset information in MAXIS that did not have supporting documentation in the case file or did not agree with the supporting documentation,
• One METS case was processed outside of 45 days, and
• One METS case did not contain the income verification documentation from the Minnesota Department of Employment and Economic Development.
Questioned Costs: Not applicable. The Western Prairie Human Services administers the program, but benefits to participants in this program are paid by the State of Minnesota.
Context: The State of Minnesota Department of Human Services (DHS) contracts with Western Prairie Human Services to perform the “intake function” needed (meeting with the social services client to determine income and categorical eligibility), while the State maintains MAXIS and METS, supporting the eligibility determination process and actually paying the benefits to participants.
The sample size was based on the guidance from chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits.
Effect: The improper input or updating of information into MAXIS and METS increases the risk that clients will receive benefits when they are not eligible.
Cause: Program personnel entering case information into MAXIS and METS did not ensure all required information was input into MAXIS and METS correctly. This was caused by human error.
Recommendation: We recommend Western Prairie Human Services implement additional procedures to provide reasonable assurance that all necessary documentation is properly input or updated in MAXIS and METS and issues are followed up on in a timely manner.
View of Responsible Official: Concur