FAC Explorer

Finding 596574 (2022-003)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2022
Accepted
2023-02-19
Audit: 22511
Organization: Edgecombe County (NC)
Auditor: Thompson Price Scott Adams & CO P A

AI Summary

  • Core Issue: There were errors in referrals between the Department of Social Services and Child Support Agencies, impacting Medicaid eligibility assessments.
  • Impacted Requirements: Compliance with Medicaid Manual MA-3365, which mandates cooperation with Child Support Enforcement for eligibility determination.
  • Recommended Follow-Up: Conduct internal reviews of case files to ensure accurate documentation and adherence to eligibility procedures.

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) CFDA # 93.778 Finding: 2022-003 IV-D Non-Cooperation SIGNIFICANT DEFICIENCY ELIGIBILITY Criteria: 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 Department of Social Services (DSS) and Child Support Agencies must be met or good cause for not cooperating must be established when determine Medicaid eligibility. Condition: There were 5 errors discovered during our procedures that referrals between DSS and Child Support Agencies were not properly made. Questioned Costs: There was no known affect to eligibility and there were no known questioned costs. Context: We examined 60 from a total of 957,769 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. Effect: 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. Cause: Human error in reading the Automated Collection and Tracking System (ACTS) report and/or ineffective case review process. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2021-008. Recommendation: 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 should clearly indicate what actions were performed and the results of those actions. Views of responsible officials and planned corrective actions: The county agrees with the finding. Please refer to the corrective action plan for details.

Categories

Eligibility Significant Deficiency

Other Findings in this Audit

  • 20129 2022-009
    Significant Deficiency
  • 20130 2022-010
    Significant Deficiency
  • 20131 2022-008
    Significant Deficiency
  • 20132 2022-003
    Significant Deficiency Repeat
  • 20133 2022-004
    Significant Deficiency Repeat
  • 20134 2022-005
    Significant Deficiency Repeat
  • 20135 2022-006
    Significant Deficiency Repeat
  • 20136 2022-007
    Significant Deficiency Repeat
  • 596571 2022-009
    Significant Deficiency
  • 596572 2022-010
    Significant Deficiency
  • 596573 2022-008
    Significant Deficiency
  • 596575 2022-004
    Significant Deficiency Repeat
  • 596576 2022-005
    Significant Deficiency Repeat
  • 596577 2022-006
    Significant Deficiency Repeat
  • 596578 2022-007
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
21.027 Coronavirus State and Local Fiscal Recovery Funds $3.07M
93.778 Medical Assistance Program $2.08M
93.563 Child Support Enforcement $1.02M
93.658 Foster Care_title IV-E $368,086
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $327,658
93.994 Maternal and Child Health Services Block Grant to the States $191,759
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $157,596
93.568 Low-Income Home Energy Assistance $155,681
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $125,663
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $125,431
21.019 Coronavirus Relief Fund $110,338
93.000 Foster Care $107,485
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $61,173
93.217 Family Planning_services $53,723
10.760 Water and Waste Disposal Systems for Rural Communities $48,196
16.001 Law Enforcement Assistance_narcotics and Dangerous Drugs_laboratory Analysis $40,140
93.991 Preventive Health and Health Services Block Grant $35,560
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $32,003
93.069 Public Health Emergency Preparedness $28,998
93.053 Nutrition Services Incentive Program $22,933
93.767 Children's Health Insurance Program $22,313
93.558 Temporary Assistance for Needy Families $21,187
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $19,187
93.645 Stephanie Tubbs Jones Child Welfare Services Program $16,124
93.556 Promoting Safe and Stable Families $14,931
20.600 State and Community Highway Safety $14,922
97.042 Emergency Management Performance Grants $12,696
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $10,685
93.268 Immunization Cooperative Agreements $10,585
93.667 Social Services Block Grant $9,786
93.659 Adoption Assistance $8,806
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $6,993
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $1,625
93.297 Teenage Pregnancy Prevention Program $1,384
97.067 Homeland Security Grant Program $574
93.000 IV-E Adoption $234
97.039 Hazard Mitigation Grant $142
93.566 Refugee and Entrant Assistance_state Administered Programs $-839