Finding Text
CASWELL COUNTY, NORTH CAROLINA
Schedule of Findings and Questioned Costs
For the Year Ended June 30, 2021
US Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medicaid Assistance Program (Medicaid; Title XIX)
CFDA# 93.778
Finding 2021-012 Inadequate Request for Information
SIGNIFICANT DEFICIENCY
Eligibility
Criteria:
Condition:
Questioned Costs:
Context:
Effect:
Cause:
Recommendation:
Views of Responsible
officials and
corrective action
plans:
Program Name: Medical Assistance Program (Medicaid; Title XIX)
CFDA #: 93.778
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.
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.
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. Electronic matches are required at applications and redeterminations.
There were 21 errors discovered during our procedures that inadequate information was
requested at applications and/or redeterminations.
Ineffective record keeping and ineffective case review process, incomplete documentation, and
incorrect application of rules for purposes of determining eligibility.
Section III. Federal Award Findings and Questioned Costs (continued)
The county agrees with the finding. Please refer to the corrective action plan for details.
SIGNIFICANT DEFICENCY: Finding 2021-009, 2021-010, 2021-011, 2021-012 also apply to State requirements and
State Awards.
Section IV. State Award Findings and Questioned Costs
We examined 60 Medicaid recipients from the Medicaid Beneficiary report provided by NC
Department of Health and Human Services to re-determine eligibility. These findings are being
reported with the financial statement audit as it relates to Medicaid administrative cost
compliance audit.
There was no known affect to eligibility and there were no known questioned costs.
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