Finding Text
CASEFILE REVIEW (2022 – 007)
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Medical Assistance Program (Medicaid Cluster)
Assistance Listing Number: 93.778
Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board
Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP
Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2022
Compliance Requirement Affected: Eligibility
Award Period: Year Ended December 31, 2022
Type of Finding: Material Weakness in Internal Control over Compliance, Other Matters
Criteria or Specific Requirement: 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: There was no formal review documented over internal case files worked by program eligibility specialists.
Questioned Costs: None
Context: During our testing of eligibility and testing of case file reviews completed during 2022 for Medical Assistance, it was noted that there were no documented case file reviews performed.
Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight.
Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible.
Repeat Finding: No
Recommendation: We recommend that the County review case files on a periodic basis throughout the year and document the review.
Views of responsible officials: There is no disagreement with the audit finding.