FAC Explorer

Finding 45525 (2022-004)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
$1
Year
2022
Accepted
2023-03-29
Audit: 51705
Organization: Department of Human Services (HI)
Auditor: Accuity LLP

AI Summary

  • Core Issue: Four providers lacked the required DHS Form 1139, and eight providers' forms did not show revalidation within the last five years.
  • Impacted Requirements: Noncompliance with 42 CFR Part 455 regarding provider screening, enrollment, and revalidation every five years.
  • Recommended Follow-Up: Increase diligence in adhering to existing policies to ensure all documentation and compliance requirements are met.

Finding Text

Condition During our audit, we selected a non statistical sample of 60 providers for testing out of a population of approximately 1,800 providers. The providers selected for testing represented approximately $240,000 of payments out of a total payment population of $7.2 million. The results of our testing were as follows: ? Four providers where the DHS Form 1139 was not maintained. ? Eight providers where the DHS Form 1139 did not support revalidation within the most recent five year period. Criteria Pursuant to 42 CFR Part 455, subpart E, the Department?s MED Quest Division is required to screen and enroll providers and obtain certain disclosure in accordance with 42 CFR Part 455, subpart B. Pursuant to 42 CFR 455.414, the State Medicaid Agency must revalidate the enrollment of all providers regardless of provider type at least every five years. Pursuant to 42 CFR 455, subpart B, Providers are to comply with the requirements of the State Plan, including the disclosure requirement. Effect Failure to follow the established policies and procedures in place over the provider eligibility determination process represents an instance of noncompliance with the requirements of 2 CFR Part 200, resulting in questioned costs. Cause and View of Responsible Officials Although the Department has policies and procedures in place requiring the maintenance of required documentation, there was a lack of diligence in complying with the policies and procedures. Recommendation We recommend the Department be more diligent in following its existing policies and procedures to ensure compliance with the program requirements.

Corrective Action Plan

Finding No. 2022 004: Special Tests and Provisions (Material Weakness) Federal Agency: Department of Health and Human Services AL Number and Title: 93.767 ? State Children?s Health Insurance Program Award Number and Award Year: 2105HI5022 Condition During our audit, we selected a non statistical sample of 60 providers for testing out of a population of approximately 1,800 providers. The providers selected for testing represented approximately $240,000 of payments out of a total payment population of $7.2 million. The results of our testing were as follows: ? Four providers where the DHS Form 1139 was not maintained. ? Eight providers where the DHS Form 1139 did not support revalidation within the most recent five year period. Views of Responding Officials The Department agrees with the finding and will implement corrective action. Corrective Action Taken or Planned The conversion to the HOKU online provider enrollment system in 2020, the staffing and workload impacts of the COVID 19 public health emergency and the inability to fill key provider enrollment section positions have combined to tax the ability of the Department to come into compliance with the stated criteria. These factors have created backlogs in the processing turnaround time for new provider enrollment applications that have been submitted by providers and are waiting to be processed by the Department. These factors have also hampered the Department?s efforts to timely outreach with providers who are at/over the five-year revalidation threshold. The Department was able to fill the section administrator over the provider enrollment section in June 2022, and also fill a key contract specialist position in August 2022. The Department entered into a new provider enrollment staff augmentation contract with Maximus effective January 1, 2023, and initial vendor performance has been promising. New provider enrollment processing time has been reduced to no more than ten days for certain provider types, and Maximus is on track to eliminate the existing provider enrollment application backlog by the third quarter of 2023. The Department is expecting these changes to result in full compliance with the stated criteria by the end of 2023. Expected Completion Date December 31, 2023 Responding Officials Jon Fujii, MED Quest Division Health Care Services Branch Administrator

Categories

Questioned Costs Eligibility

Other Findings in this Audit

  • 45457 2022-015
    Material Weakness
  • 45458 2022-015
    Material Weakness
  • 45459 2022-008
    Material Weakness Repeat
  • 45460 2022-008
    Material Weakness Repeat
  • 45461 2022-009
    Material Weakness Repeat
  • 45524 2022-009
    Material Weakness Repeat
  • 45526 2022-005
    Material Weakness Repeat
  • 45527 2022-010
    Material Weakness Repeat
  • 45528 2022-011
    Material Weakness Repeat
  • 45529 2022-012
    Material Weakness Repeat
  • 45530 2022-013
    Material Weakness Repeat
  • 45531 2022-014
    Significant Deficiency
  • 45532 2022-016
    Material Weakness
  • 45533 2022-010
    Material Weakness Repeat
  • 45534 2022-011
    Material Weakness Repeat
  • 45535 2022-012
    Material Weakness Repeat
  • 45573 2022-013
    Material Weakness Repeat
  • 45574 2022-014
    Significant Deficiency
  • 45575 2022-016
    Material Weakness
  • 45576 2022-002
    Material Weakness Repeat
  • 45577 2022-003
    Material Weakness Repeat
  • 45578 2022-002
    Material Weakness Repeat
  • 45579 2022-003
    Material Weakness Repeat
  • 45580 2022-002
    Material Weakness Repeat
  • 45581 2022-003
    Material Weakness Repeat
  • 45582 2022-006
    Material Weakness Repeat
  • 45583 2022-007
    Material Weakness Repeat
  • 45584 2022-017
    Significant Deficiency Repeat
  • 45585 2022-006
    Material Weakness Repeat
  • 45586 2022-007
    Material Weakness Repeat
  • 45587 2022-017
    Significant Deficiency Repeat
  • 45588 2022-006
    Material Weakness Repeat
  • 45589 2022-007
    Material Weakness Repeat
  • 45590 2022-017
    Significant Deficiency Repeat
  • 621899 2022-015
    Material Weakness
  • 621900 2022-015
    Material Weakness
  • 621901 2022-008
    Material Weakness Repeat
  • 621902 2022-008
    Material Weakness Repeat
  • 621903 2022-009
    Material Weakness Repeat
  • 621966 2022-009
    Material Weakness Repeat
  • 621967 2022-004
    Material Weakness Repeat
  • 621968 2022-005
    Material Weakness Repeat
  • 621969 2022-010
    Material Weakness Repeat
  • 621970 2022-011
    Material Weakness Repeat
  • 621971 2022-012
    Material Weakness Repeat
  • 621972 2022-013
    Material Weakness Repeat
  • 621973 2022-014
    Significant Deficiency
  • 621974 2022-016
    Material Weakness
  • 621975 2022-010
    Material Weakness Repeat
  • 621976 2022-011
    Material Weakness Repeat
  • 621977 2022-012
    Material Weakness Repeat
  • 622015 2022-013
    Material Weakness Repeat
  • 622016 2022-014
    Significant Deficiency
  • 622017 2022-016
    Material Weakness
  • 622018 2022-002
    Material Weakness Repeat
  • 622019 2022-003
    Material Weakness Repeat
  • 622020 2022-002
    Material Weakness Repeat
  • 622021 2022-003
    Material Weakness Repeat
  • 622022 2022-002
    Material Weakness Repeat
  • 622023 2022-003
    Material Weakness Repeat
  • 622024 2022-006
    Material Weakness Repeat
  • 622025 2022-007
    Material Weakness Repeat
  • 622026 2022-017
    Significant Deficiency Repeat
  • 622027 2022-006
    Material Weakness Repeat
  • 622028 2022-007
    Material Weakness Repeat
  • 622029 2022-017
    Significant Deficiency Repeat
  • 622030 2022-006
    Material Weakness Repeat
  • 622031 2022-007
    Material Weakness Repeat
  • 622032 2022-017
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
93.778 Medical Assistance Program $2.00B
10.551 Supplemental Nutrition Assistance Program $985.58M
93.558 Temporary Assistance for Needy Families $53.33M
93.767 Children's Health Insurance Program $47.66M
10.542 Pandemic Ebt Food Benefits $35.77M
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $26.06M
93.575 Child Care and Development Block Grant $24.44M
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $15.96M
15.875 Economic, Social, and Political Development of the Territories $15.80M
93.659 Adoption Assistance $14.60M
93.658 Foster Care_title IV-E $12.89M
93.667 Social Services Block Grant $10.17M
84.126 Rehabilitation Services_vocational Rehabilitation Grants to States $9.23M
96.001 Social Security_disability Insurance $7.24M
93.568 Low-Income Home Energy Assistance $4.93M
93.090 Guardianship Assistance $3.89M
93.556 Promoting Safe and Stable Families $2.09M
21.027 Coronavirus State and Local Fiscal Recovery Funds $1.66M
10.649 Pandemic Ebt Administrative Costs $1.17M
93.645 Stephanie Tubbs Jones Child Welfare Services Program $1.01M
93.777 State Survey and Certification of Health Care Providers and Suppliers (title Xviii) Medicare $833,539
84.426 Randolph-Sheppard Financial Relief and Restoration Payments $498,584
14.231 Emergency Solutions Grant Program $479,326
93.464 Acl Assistive Technology $455,502
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $430,989
93.369 Acl Independent Living State Grants $403,424
94.011 Foster Grandparent Program $381,732
14.241 Housing Opportunities for Persons with Aids $303,703
93.599 Chafee Education and Training Vouchers Program (etv) $288,510
16.540 Juvenile Justice and Delinquency Prevention_allocation to States $281,422
94.016 Senior Companion Program $222,793
93.671 Family Violence Prevention and Services/domestic Violence Shelter and Supportive Services $199,692
10.535 Snap Fraud Framework Implementation Grant $180,000
93.669 Child Abuse and Neglect State Grants $164,367
84.177 Rehabilitation Services_independent Living Services for Older Individuals Who Are Blind $77,730
17.235 Senior Community Service Employment Program $70,569
93.643 Children's Justice Grants to States $68,971
84.187 Supported Employment Services for Individuals with the Most Significant Disabilities $49,893
16.738 Edward Byrne Memorial Justice Assistance Grant Program $21,531
16.588 Violence Against Women Formula Grants $16,150
10.545 Farmers? Market Supplemental Nutrition Assistance Program Support Grants $12,960
93.566 Refugee and Entrant Assistance_state Administered Programs $9,000
93.747 Elder Abuse Prevention Interventions Program $8,043