Finding 580913 (2023-001)

Special Tests and Provisions (Enterprise Program Integrity) Criteria: Per the North Carolina DSS Crosscutting Requirements compliance supplement, counties must acquire adequate case documentation to substantiate the claim entry into the Enterprise Program Integrity (EPI). This information includes but is not limited to the dates of the overpayment period, documentary evidence to substantiate that an overpayment occurred, such as wage stubs or verification from an employer, other income verification and household composition verification, and the budgets used to compute the amount of the overpayment. This also includes proper use of standardized form 1682. Condition: We noted one instance of a Food and Nutrition services claim entered in EPI where adequate case documentation was not maintained. The case file did not include a signed form 1682. Context: We sampled 40 claims that were current in the EPI system and noted the above condition in 1 (2.5%) of the claims tested. Effect: The County may not have required supporting documentation for claims entered into the EPI system. There is a risk that claims may not be valid as a result. Cause: Turnover in supervisor position left duties unfulfilled and an unsigned Form 1682 in the case file. Questioned Costs: The finding represents an internal control weakness; therefore, no questioned costs are applicable. Upon further review, the case was still eligible to report a claim entry into EPI. Recommendation: The County should implement controls to ensure that all required documentation is adequate and maintained within the case file. Views of Responsible Officials and Planned Corrective Actions: See Corrective Action Plan submitted with this report.