Finding Text
US Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL #: 93.778
Finding: 2023-005 IV-D Cooperation with Child Support
SIGNIFICANT DEFICENCY
Eligibility
Criteria:
Condition:
Questioned Costs:
Context:
Effect:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
Program Name: Medical Assistance Program (Medicaid; Title XIX)
AL# 93.778
SIGNIFICANT DEFICENCY: Finding 2023- 002, 2023-003, 2023-004, 2023-005 also apply to State requirements and State Awards.
Section IV - State Award Findings and Questioned Costs
Section III. Federal Award Findings and Questioned Costs (continued)
In accordance with the Medicaid Manual MA-3365, all Medicaid cases should be evaluated and referred to the
Child Support Enforcement Agency (IV-D). The Child Support Enforcement Agency (IV-D) can assist the family
in obtaining financial and/or medical support or medical support payments from the child’s non-custodial parent.
Cooperation requirement with Social Services and Child Support Agencies must be met or good cause for not
cooperating must be established when determining Medicaid eligibility.
There were 3 errors discovered during our procedures that referrals between Department of Social Services
(DSS) and Child Support Agencies were not made.
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.
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.
The County agrees with the finding. See Corrective Action Plan in the following section.
Human error in reading the Automated Collection and Tracking System (ACTS) report and/or ineffective case
review process.
Files should be reviewed internally to ensure proper information is in place and necessary procedures are taken
when determine eligibility. The results found or documentation made in case notes that clearly indicates what
actions were performed and the results of those actions.