Finding Text
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance (Medicaid Cluster), Foster Care – Title IV-E
Assistance Listing Number: 93.778, 93.658
Pass-Through Agency: Minnesota Department of Human Services
Pass-Through Numbers: 2305MN5MAP, 2305MN5ADM, 2301MNFOST
Federal Award Identification Number and Year: 2305MN5MAP, 2305MN5ADM, 2301MNFOST, 2023
Compliance Requirement Affected: Eligibility
Award Period: Year Ending December 31, 2023
Type of Finding: Significant Deficiency in Internal Control over Compliance
Criteria or Specific Requirement: Title 2 U.S. Code of Federal Regulations § 200.303 states that the auditee must establish and maintain effective internal control over the federal award that provides reasonable assurance that the auditee is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award. Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements and correctly determining program eligibility.
Condition: The county is not performing internal casefile reviews of medical assistance or foster care cases.
Questioned Costs: None.
Context: During our testing of eligibility and testing of case file reviews completed during 2023 for Medical Assistance (Medicaid Cluster) and Foster Care – Title IV-E, it was noted that there were no documented case file reviews performed.
Cause: Since the pandemic ended, the eligibility guidance has been changing rapidly, and the county is short staffed.
Effect: The county could be reporting inaccurate information affecting the status of eligibility.
Repeat Finding: Yes, Finding 2022-005 over Medicaid Cluster only
Recommendation: We recommend the County review case files on a periodic basis throughout the year and document the reviews.
Views of Responsible Officials and Planned Corrective Actions: There is no disagreement with the audit finding. The County will implement and document procedures for periodic review of cash files to ensure eligibility requirements are being met.