Finding 512965 (2024-002)

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: 2024-002 SIGNIFICANT DEFICIENCY ELIGIBILITY Criteria: Condition: Questioned Costs: Context: Section III. Federal Award Findings and Questioned Costs Section II. Financial Statement Findings The County's management and other users of the financial statements do not have accurate information for decisions-making and monitoring of the county's financial position and adherence to laws, regulations, and other requirements. Errors in financial reporting could occur and not be detected. The original net present values recorded for several GASB 87 leases were incorrectly calculated. The County should keep good record of the lease schedules and make adjustments timely. The County agrees with this finding. In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a recipient meets specific standards, and documentation must be maintained to support eligibility determinations. In accordance with 2 CFR 200, management should have an adequate system of internal controls procedures in place to ensure an applicant is properly determined or redetermined for benefits. There were 5 errors discovered during our procedures that inaccurate information was entered when determining eligibility. There was no known affect to eligibility and there were no known questioned costs. We examined 60 cases from of a total of 650,440 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. Effect: Identification of a repeat finding: Cause: Recommendation: Views of responsible officials and planned corrective actions: Finding: 2024-003 Inadequate Request For Information SIGNIFICANT DEFICIENCY ELIGIBILITY Criteria: Condition: Questioned Costs: Context: This is a repeat finding from the immediate previous audit, 2023-002. Section III. Federal Award Findings and Questioned Costs (continued) Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining Files should be reviewed internally to ensure proper documentation is in place for eligibility. Workers should be retrained on what files should contain and the importance of complete and accurate record keeping. We recommend that all files include online verifications, documented resources of income and those amounts agree to information in NC FAST. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. The County agrees with the finding. See Corrective Action Plan in the following section.