Finding 579596 (2023-004)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2023
Accepted
2023-12-04
Audit: 5141
Organization: Yadkin County (NC)

AI Summary

  • Core Issue: Inadequate documentation and record-keeping led to potential eligibility errors in the Medicaid program.
  • Impacted Requirements: Compliance with 42 CFR 435, which mandates proper documentation for eligibility determinations.
  • Recommended Follow-Up: Conduct internal reviews, retrain staff on documentation standards, and ensure all files include necessary verifications and accurate case notes.

Finding Text

US Department of Health and Human Services Passed through the NC Dept. of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) AL# 93.778 Finding: 2023-004 Inadequate Request for Information SIGNIFICANT DEFICENCY Eligibility Criteria: Condition: Questioned Costs: Context: Effect: Identification of a repeat finding: Cause: Recommendation: Views of responsible officials and planned corrective actions: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST and applicants could have been approved for benefits for which they were not eligible. Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. 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 and 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. 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 5 errors discovered during our procedures that inadequate information was requested at applications and/or redeterminations. There was no known affect to eligibility and there were no known questioned costs. We examined 60 cases from of a total of 370,977 Medicaid claims 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. This is a repeat finding from the immediate previous audit, 2022-005. The County agrees with the finding. See Corrective Action Plan in the following section.

Categories

Eligibility

Other Findings in this Audit

  • 3152 2023-002
    Significant Deficiency Repeat
  • 3153 2023-003
    Significant Deficiency Repeat
  • 3154 2023-004
    Significant Deficiency Repeat
  • 3155 2023-005
    Significant Deficiency
  • 579594 2023-002
    Significant Deficiency Repeat
  • 579595 2023-003
    Significant Deficiency Repeat
  • 579597 2023-005
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.778 Medical Assistance Program $825,086
93.658 Foster Care_title IV-E $464,277
93.563 Child Support Enforcement $275,706
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $200,657
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $85,905
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $81,890
93.977 Preventive Health Services_sexually Transmitted Diseases Control Grants $59,134
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $53,460
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $49,739
93.994 Maternal and Child Health Services Block Grant to the States $47,762
10.916 Watershed Rehabilitation Program $45,962
93.268 Immunization Cooperative Agreements $43,325
93.217 Family Planning_services $34,773
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $31,639
93.767 Children's Health Insurance Program $29,113
93.991 Preventive Health and Health Services Block Grant $28,828
93.053 Nutrition Services Incentive Program $26,095
93.556 Promoting Safe and Stable Families $26,091
93.110 Maternal and Child Health Federal Consolidated Programs $23,161
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $22,186
93.069 Public Health Emergency Preparedness $21,721
93.659 Adoption Assistance $17,918
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $15,399
97.042 Emergency Management Performance Grants $12,500
93.667 Social Services Block Grant $12,210
93.645 Stephanie Tubbs Jones Child Welfare Services Program $8,558
93.568 Low-Income Home Energy Assistance $7,117
93.000 Foster Care $4,295
93.558 Temporary Assistance for Needy Families $4,025
21.027 Coronavirus State and Local Fiscal Recovery Funds $299
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $34
93.566 Refugee and Entrant Assistance_state Administered Programs $1