Finding 401537 (2022-001)

Section III — Findings and Questioned Costs – Major Federal Programs Reference Number: 2022-001 Prior Year Finding: No Federal Agency: U.S. Department of Health and Human Services Pass through: Hoopa Valley Tribe Federal Program: Tribal Self-Governance Program: IHS Compacts/Funding Agreements Assistance Listing Number: 93.210 Award Number and Year: 66G930003 Compliance Requirement: Eligibility Type of Finding: Material Weakness Criteria – Grant conditions and federal regulations require that grantees verify eligibility before providing services and maintain records documenting such eligibility. Condition – We noted that the Medical Center did not have controls in place to ensure that all eligibility determinations were properly supported per the Medical Center’s policies and procedures. For eight of 25 participants selected, the supporting documentation to determine eligibility was not retained. Questioned Costs – The calculation of questioned costs was not determinable for these instances of noncompliance. Cause – The Medical Center did not follow its policies and procedures for documenting eligibility, which include sufficient monitoring or other verification that participants are eligible and that documentation of eligibility is maintained. Effect – Without strong controls over participant eligibility, ineligible participants may benefit from programs. Recommendation – All programs should reexamine processes and controls over participant eligibility, including ensuring that documentation is retained for all participants.