Finding 518453 (2024-001)

U.S. Department of Health and Human Services Passed through the N.C. Department of Health and Human Services, Division of Social Services Program Name: DSS Crosscutting (State) Supplemental Nutrition Assistance Program AL#10.561 Finding 2024-001 Significant Deficiency Criteria: Per the North Carolina DSS Crosscutting Requirements, Counties must acquire adequate case documentation to substantiate the claim entry into the NC Fast Enterprise Program Integrity (“EPI”) system. This information includes, but is not limited to, the dates of the overpayment period, documentary evidence to substantiate that an overpayment occurred, such as wage stubs or verification from an employer, other income verification and household composition verification, and the budgets used to compute the amount of the overpayment. Condition: We noted four instances of a Food and Nutrition Services claim entered in EPI where adequate case documentation to substantiate the claim entry were not maintained. Two of those instances were due to the form 1682 not being located, one instance was due to the form 1682 not being signed, and the other instance was due to the calculation of form 1682 being incorrect. The claims were determined to still valid. No questioned costs resulted from these cases. Context: We sampled 18 claims that were current in the EPI system and noted the above condition in 4 (22%) of the claims tested. To date, the County has reviewed the claims found above and placed the correct form 1682 in the casefile. Effect: The County may not have accurate supporting documentation for claims entered in EPI system. There is a risk that claims may not be valid as a result. Cause: Documentation to support a claim entered into EPI was not located, signed, or accurate. Questioned Costs: None. The finding represents an internal control issue; therefore, no questioned costs are applicable. Recommendation: County DSS staff should implement controls to ensure that all documentation is maintained, reviewed, and accurate. Views of Responsible Officials and Planned Corrective Action: Management concurs with this finding and will adhere to the Corrective Action Plan in this audit report.