Finding Text
US Department of Health and Human Service
Passed through the NC Dept of Health and Human Services
SIGNIFICANT DEFICIENCY
Eligibility
Criteria:
Condition:
In accordance with the Single Audit Act of 1984 (amended in 1996), and the Office of
Management and Budget (OMB) Title 2 U.S. Code of Federal Regulations (CFR) Part 200,
Uniform Administrative Requirements for Federal Awards (Uniform Guidance), a single
audit reporting package and data collection form is required to submitted to the Federal
Audit Clearinghouse (FAC) 30 days after receipt of the auditor's report, or 9 months after
the end of the fiscal year, whichever comes first.
The audit report was not finalized until 10 months after year end.
Federal agencies that provide funding and other public associations need current financial
information about each unit of local government.
The County's audits have been submitted late over the past several years. The County was
unable to provide information necessary to complete the audit timely as a result of staffing
issues.
The County should allocate sufficient resources to ensure that all records are reconciled
timely to allow time for the audit to be completed timely.
There was no known affect to eligibility and there were no known questioned costs.
Section III - Federal Award Findings and Questioned Costs
Program Names: Medical Assistance
AL # 93.778
Finding: 2023-005 Inadequate Request for Information
In accordance with 42 CFR 435, documentation must be obtained as needed to determine if
a recipient meets specific standards, and documentation must be maintained to support
eligibility determinations. Electronic matches are required at applications and
redeterminations.
There were 8 errors discovered during our procedures that inadequate information was
requested at applications and/or redeterminations.
Context:
Effect:
Cause:
US Department of Health and Human Service
Passed through the NC Dept of Health and Human Services
Finding: 2023-006
SIGNIFICANT DEFICIENCY
Eligibility
Criteria:
Condition:
Identification of a repeat
finding:
This is a repeat finding from the immediate previous audit, 2022-006.
Section III - Federal Award Findings and Questioned Costs (continued)
Views of Responsible
Officials and Planned
Corrective Actions:
The county agrees with this finding. See corrective action plan.
Program Names: Medical Assistance
AL # 93.778
IV-D Non-Cooperation
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.
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 applicants could have been approved for benefits for
which they were not eligible.
We examined 60 cases from of a total of 331,466 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.
Recommendation: Files should be reviewed internally to ensure proper documentation is in place for
eligibility. Workers should be retrained on what files should contain and the importance of
complete and accurate record keeping. We recommend that all files include online
verifications, documented resources and income and those amounts agree to information in
NC FAST. The results found or documentation made in case notes should clearly indicate
what actions were performed and the results of those actions.
Ineffective record keeping and ineffective case review process, incomplete documentation,
and incorrect application of rules for purposes of determining eligibility.
There were 2 errors discovered during our procedures that referrals between DSS and
Child Support Agencies were not properly made.
Questioned Costs: There was no known affect to eligibility and there were no known questioned costs.
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