FAC Explorer

Finding 43002 (2022-005)

Significant Deficiency
Requirement
E
Questioned Costs
-
Year
2022
Accepted
2023-04-24
Audit: 39106
Organization: Scotland County of North Carolina (NC)
Auditor: Thompson Price Scott Adams & CO P A

AI Summary

  • Core Issue: Medicaid cases are not being properly referred to the Child Support Enforcement Agency, leading to potential eligibility errors.
  • Impacted Requirements: Compliance with Medicaid Manual MA-3365, which mandates cooperation with Child Support Agencies for eligibility determinations.
  • Recommended Follow-Up: Conduct internal reviews of case files to ensure accurate documentation and adherence to eligibility procedures.

Finding Text

US Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) AL #: 93.778 Finding: 2022-005 IV-D Cooperation with Child Support SIGNIFICANT DEFICENCY Eligibility Criteria: 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 Department of Social Services (DSS) and Child Support Agencies must be met or good cause for not cooperating must be established when determine Medicaid eligibility. Condition: There were 7 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. Context: We examined 60 from a total of 683,004 Medicaid claims from the Medicaid beneficiary report provided by NC Department of Health and Human Services to re-determine eligibility. These findings are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: 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 a participant could have been approved for benefits for which they were not eligible. Cause: Human error in reading the Automated Collection and Tracking System (ACTS) report and/or ineffective case review process. Recommendation: Files should be reviewed internally to ensure proper information is in place and necessary procedures are taken when determine eligibility. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. Views of responsible officials and planned corrective actions: The County agrees with the finding.

Corrective Action Plan

Finding: 2022-005 Name of contact person: Carolyn Lewellen, Medicaid Program Manager Corrective action: Family Medicaid Supervisor has trained staff on when completing a child support referral is required. Targeted reviews will be completed by the Family Medicaid Supervisor for 3 months, 2 reviews for each staff member. Proposed completion date: Training was completed on 9/20/2022 with Medicaid staff. Training logs available. Targeted reviews began on 12/1/2022 and end on 2/28/2023, if appropriate referrals were made and documented. Review logs will document those targeted reviews. Quality Assurance staff will review findings, recommendations, and make any adjustments needed to 2nd party forms.

Categories

Eligibility

Other Findings in this Audit

  • 43001 2022-004
    Significant Deficiency
  • 43003 2022-006
    Significant Deficiency Repeat
  • 43004 2022-007
    Significant Deficiency
  • 43005 2022-008
    Significant Deficiency
  • 43006 2022-009
    Significant Deficiency
  • 619443 2022-004
    Significant Deficiency
  • 619444 2022-005
    Significant Deficiency
  • 619445 2022-006
    Significant Deficiency Repeat
  • 619446 2022-007
    Significant Deficiency
  • 619447 2022-008
    Significant Deficiency
  • 619448 2022-009
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.778 Medical Assistance Program $1.64M
21.027 Coronavirus State and Local Fiscal Recovery Funds $846,118
93.658 Foster Care_title IV-E $718,411
93.563 Child Support Enforcement $700,685
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $226,060
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $144,378
93.268 Immunization Cooperative Agreements $133,750
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $93,559
93.994 Maternal and Child Health Services Block Grant to the States $79,021
16.034 Coronavirus Emergency Supplemental Funding Program $55,725
93.000 Foster Care $43,658
93.217 Family Planning_services $32,788
93.991 Preventive Health and Health Services Block Grant $30,608
93.069 Public Health Emergency Preparedness $22,581
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $21,181
93.767 Children's Health Insurance Program $17,112
20.509 Formula Grants for Rural Areas and Tribal Transit Program $15,763
97.042 Emergency Management Performance Grants $12,695
93.667 Social Services Block Grant $11,829
93.645 Stephanie Tubbs Jones Child Welfare Services Program $11,523
93.558 Temporary Assistance for Needy Families $10,163
20.703 Interagency Hazardous Materials Public Sector Training and Planning Grants $8,000
93.568 Low-Income Home Energy Assistance $7,050
93.556 Promoting Safe and Stable Families $6,801
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $4,206
16.607 Bulletproof Vest Partnership Program $1,920
93.659 Adoption Assistance $673
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $450
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $421
93.977 Preventive Health Services_sexually Transmitted Diseases Control Grants $100
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $50
93.566 Refugee and Entrant Assistance_state Administered Programs $-1,291