Finding 541800 (2023-004)

2023-004 Eligibility Prior Year Finding Number: N/A Year of Finding Origination: 2023 Type of Finding: Internal Control Over Compliance and Compliance Severity of Deficiency: Significant Deficiency and Other Matter Federal Agency: U.S. Department of Health and Human Services Program: 93.778 Medical Assistance Program Award Number and Year: 2305MN5ADM; 2023 Pass-Through Agency: Minnesota Department of Human Services Criteria: 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. Condition: The Minnesota Department of Human Services (DHS) maintains the computer systems, METS and MAXIS, which are used by Lake County to support the eligibility determination process. In the case files reviewed for eligibility, not all documentation was available, updated, or input correctly to support participant eligibility. The following exceptions were noted in the sample of 40 MAXIS and 40 METS case files tested: • In METS, three case files did not contain documentation that social security numbers were verified. Additionally, two of those three files did not contain documentation that citizenship was verified. • In MAXIS, there was one instance where judicial determination or voluntary placement agreement for Foster Care was missing. Questioned Costs: Not applicable. The County administers the program, but the State of Minnesota pays benefits to participants in this program. Context: The State of Minnesota and Lake County Public Health and Human Services split the eligibility determination process. Pursuant to Minnesota statutes, Lake County Public Health and Human Services performs the “intake function” needed for this program, while the state maintains the MAXIS and METS systems, which support the eligibility determination process. Participants receive benefit payments from the state. The sample size was based on guidance from Chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits. Effect: The lack of updated information in MAXIS and METS documenting verification of key eligibility-determining factors increases the risk that program participants will receive benefits when they are not eligible. Cause: Program personnel entering case information into MAXIS and METS did not ensure all required information was obtained or retained. Recommendation: We recommend the County implement additional procedures to provide reasonable assurance that all necessary documentation to support eligibility determinations is obtained, retained, and properly input or updated in MAXIS and METS. In addition, Lake County should consider providing further training to program personnel. View of Responsible Official: Concur