Finding 609256 (2022-003)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2022
Accepted
2022-11-14
Audit: 29375
Organization: Yadkin County (NC)

AI Summary

  • Core Issue: Inaccurate information entry during eligibility determinations for Medicaid, leading to potential misclassification of recipients.
  • Impacted Requirements: Non-compliance with 42 CFR 435 and 2 CFR 200 regarding documentation and internal controls for eligibility assessments.
  • Recommended Follow-Up: Conduct internal reviews of files, retrain staff on documentation standards, and ensure all eligibility files include necessary verifications and clear 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: 2022-003 Inaccurate Information Entry SIGNIFICANT DEFICENCY Eligibility Criteria: 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. In accordance with 2 CFR 200, management should have an adequate system of internal controls procedures in place to ensure an applicant is properly determined or redetermined for benefits. Condition: There were 7 errors discovered during our procedures that inaccurate information was entered when determining eligibility. Questioned Costs: There was no known affect to eligibility and there were no known questioned costs. Context: We examined 60 of a total of 397,158 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 NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2021-002 Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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 of 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. Views of responsible officials and planned corrective actions: The County agrees with the finding.

Categories

Eligibility Internal Control / Segregation of Duties

Other Findings in this Audit

  • 32813 2022-002
    Significant Deficiency
  • 32814 2022-003
    Significant Deficiency Repeat
  • 32815 2022-004
    Significant Deficiency Repeat
  • 32816 2022-005
    Significant Deficiency Repeat
  • 609255 2022-002
    Significant Deficiency
  • 609257 2022-004
    Significant Deficiency Repeat
  • 609258 2022-005
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
21.027 Coronavirus State and Local Fiscal Recovery Funds $7.32M
93.778 Medical Assistance Program $832,791
93.658 Foster Care_title IV-E $519,361
10.916 Watershed Rehabilitation Program $459,446
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $278,707
93.563 Child Support Enforcement $268,866
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $214,567
93.268 Immunization Cooperative Agreements $80,885
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $79,683
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $70,583
93.000 Foster Care $69,835
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $50,438
93.994 Maternal and Child Health Services Block Grant to the States $47,935
16.738 Edward Byrne Memorial Justice Assistance Grant Program $47,552
93.767 Children's Health Insurance Program $37,448
93.556 Promoting Safe and Stable Families $34,556
93.217 Family Planning_services $33,862
93.053 Nutrition Services Incentive Program $28,596
93.991 Preventive Health and Health Services Block Grant $24,558
93.069 Public Health Emergency Preparedness $19,650
93.645 Stephanie Tubbs Jones Child Welfare Services Program $13,478
93.659 Adoption Assistance $11,909
93.568 Low-Income Home Energy Assistance $11,591
93.052 National Family Caregiver Support, Title Iii, Part E $11,111
97.042 Emergency Management Performance Grants $11,068
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $8,965
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $8,958
93.667 Social Services Block Grant $7,935
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $6,713
93.558 Temporary Assistance for Needy Families $4,025
93.977 Preventive Health Services_sexually Transmitted Diseases Control Grants $2,223
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $50