Finding 4491 (2023-001)

Material Weakness
Requirement
ABL
Questioned Costs
-
Year
2023
Accepted
2023-12-15

AI Summary

  • Core Issue: UW Health lacked effective internal controls over allowable costs and reporting for the COVID-19 Provider Relief Fund, leading to significant revenue misstatements.
  • Impacted Requirements: Compliance with 2 CFR 200.303(a) and HRSA reporting guidance was not met, resulting in an overstatement of 2020 revenues by $10,000 and an understatement of 2021 revenues by $1,000,002.
  • Recommended Follow-Up: Management should provide training for staff on internal control procedures to ensure compliance with federal and state grant requirements.

Finding Text

2023-001 Activities Allowed or Unallowed, Allowable Costs/Cost Principles and Reporting; Federal Agency: U.S. Department of Health and Human Services; Program: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (ALN 93.498); Pass-through Entity: N/A; Federal Assistance Identification Number or Pass-Through Number: N/A; Federal Award Year: Year ended June 30, 2023; Type of Finding: Material Weakness in Internal Control over Compliance; Other Matter Compliance Finding; Criteria: 2 CFR 200.303(a) requires that each non-Federal entity must "Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award."; In addition, per the Health Resources and Services Administration (HRSA) reporting guidance, providers who accepted provider relief fund (PRF) payments agreed to the Terms and Conditions of the program, which included a requirement to report on the use of funds. Providers who received one or more payments totaling greater than $10,000 in the aggregate during a payment received period must report on use of funds in each applicable reporting period. Condition: UW Health did not maintain effective internal controls over allowable costs, cost principles and reporting for the PRF program for Periods 4 and 5. In addition, during our testing we noted errors in the amount of revenue reported in the portal. This resulted in an overstatement of actual 2020 revenues of $10,000 and an understatement of actual 2021 revenues of $1,000,002 on the Period 4 and Period 5 portal submissions, respectively, for the University of Wisconsin Medical Foundation, Inc. (UWMF). Cause: The client did not perform internal control procedures that had been in place in previous years as much of the information in the PRF submission had been reviewed previously. Effect: Revenue reported in the UWMF's PRF reporting portal was misstated for several quarters, resulting in a total overstatement of actual 2020 revenues of $10,000, and a total understatement of actual 2021 revenues of $1,000,002. However, if the revenues were reported correctly, it would have still resulted in enough lost revenue to fully earn the funds received. Context: The errors were present in the UWMF reporting submissions completed for reporting Period 4 and 5. Questioned Costs: None; Repeat Finding?: No; Recommendation: We recommend management conduct training with individuals involved in the administration of federal and state grants to stress the importance of performing internal control activities for all compliance requirements. View of responsible officials of the auditee: Management agrees with the finding. See corrective action plan.

Corrective Action Plan

Finding number: 2023-001; Finding: UW Health did not maintain effective internal controls over allowable costs, cost principles and reporting for the PRF program for Periods 4 and 5. In addition, during our testing we noted errors in the amount of revenue reported in the portal. This resulted in an overstatement of actual 2020 revenues of $10,000 and an understatement of actual 2021 revenues of $1,000,002 on the Period 4 and Period 5 portal submissions, respectively, for the University of Wisconsin Medical Foundation, Inc. (UWMF). Correction actions taken or planned: A systematic approach will be utilized to identify compliance reporting requirements. A secondary review of Provider Relief Fund reporting, if applicable in the future, will be documented and approved prior to final submission. Anticipated completion Date: December 2023; UW Health employees responsible for Corrective Action Plan: Heather Brahm, Director of Finance & Controller, and Jamie Soyk, Program Director of Financial Reporting

Categories

Allowable Costs / Cost Principles Subrecipient Monitoring Material Weakness Reporting Matching / Level of Effort / Earmarking

Other Findings in this Audit

  • 4492 2023-002
    Significant Deficiency
  • 4493 2023-003
    Material Weakness
  • 580933 2023-001
    Material Weakness
  • 580934 2023-002
    Significant Deficiency
  • 580935 2023-003
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $26.99M
93.647 Social Services Research and Demonstration $887,417
93.959 Block Grants for Prevention and Treatment of Substance Abuse $432,204
93.778 Medical Assistance Program $396,480
93.153 Coordinated Services and Access to Research for Women, Infants, Children, and Youth $75,761
93.917 Hiv Care Formula Grants $69,716
93.217 Family Planning_services $60,432
93.110 Maternal and Child Health Federal Consolidated Programs $24,730
93.080 Blood Disorder Program: Prevention, Surveillance, and Research $12,072
93.667 Social Services Block Grant $7,656
93.558 Temporary Assistance for Needy Families $4,069