FAC Explorer

Finding 477865 (2023-008)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2023
Accepted
2024-07-08
Audit: 314504
Organization: Vance County (NC)
Auditor: Thompson Price Scott Adams & CO

AI Summary

  • Core Issue: There were errors in referrals between the Department of Social Services (DSS) and Child Support Agencies, impacting Medicaid eligibility evaluations.
  • Impacted Requirements: Compliance with Medicaid Manual MA-3365, which mandates cooperation with Child Support Enforcement for eligibility determination.
  • Recommended Follow-Up: Conduct internal reviews of case files to ensure accurate documentation and adherence to eligibility procedures.

Finding Text

U.S. 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: 2023-008 IV-D Cooperation with Child Support SIGNIFICANT DEFICENCY Eligibility Criteria: Condition: Questioned Costs: Context: Effect: Cause: Identification of a repeat finding: Recommendation: Views of responsible officials and planned corrective actions: The County agrees with the finding. 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. There were 2 errors discovered during our procedures that referrals between DSS and Child Support Agencies were not properly made. There was no known affect to eligibility and there were no known questioned costs. We examined 60 cases from of a total of 804,789 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. 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. This is a repeat finding from the immediate previous audit, 2022-004. Human error in reading the Automated Collection and Tracking System (ACTS) report and/or ineffective case review process. Files should be reviewed internally to ensure proper information is in place and necessary procedures are taken when determining eligibility. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions.

Corrective Action Plan

Finding 2023-007 Name of contact person: Stephanie Williams, Budget and Finance Director Corrective Action: Proposed Completion Date: Finding 2023-008 Name of contact person: Corrective Action: Proposed Completion Date: During the period in which the audited items determinations took place, this was a requirement. However, currently this requirement is no longer required due to changes in policy. N/A Goldie Davis, IM Program Manager Ongoing We will review the requirements of the grant agreement and facilitate the steps necessary to ensure all compliance requirements are met. Ongoing

Categories

Eligibility

Other Findings in this Audit

  • 477864 2023-007
    Significant Deficiency
  • 477866 2023-009
    Significant Deficiency Repeat
  • 477867 2023-010
    Significant Deficiency Repeat
  • 477868 2023-011
    Significant Deficiency Repeat
  • 477869 2023-012
    Significant Deficiency Repeat
  • 1054306 2023-007
    Significant Deficiency
  • 1054307 2023-008
    Significant Deficiency Repeat
  • 1054308 2023-009
    Significant Deficiency Repeat
  • 1054309 2023-010
    Significant Deficiency Repeat
  • 1054310 2023-011
    Significant Deficiency Repeat
  • 1054311 2023-012
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
21.027 Coronavirus State and Local Fiscal Recovery Funds $2.25M
93.778 Medical Assistance Program $1.38M
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $747,788
93.568 Low-Income Home Energy Assistance $720,596
93.558 Temporary Assistance for Needy Families $392,319
93.667 Social Services Block Grant $355,409
93.658 Foster Care_title IV-E $206,987
93.563 Child Support Enforcement $194,507
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $171,400
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $152,960
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $82,937
93.659 Adoption Assistance $40,481
97.042 Emergency Management Performance Grants $39,032
16.738 Edward Byrne Memorial Justice Assistance Grant Program $30,771
93.767 Children's Health Insurance Program $16,869
93.053 Nutrition Services Incentive Program $16,531
93.645 Stephanie Tubbs Jones Child Welfare Services Program $10,627
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $10,209
93.052 National Family Caregiver Support, Title Iii, Part E $4,239
93.556 Promoting Safe and Stable Families $2,591
93.566 Refugee and Entrant Assistance_state Administered Programs $18