FAC Explorer

Finding 611031 (2022-002)

Significant Deficiency
Requirement
E
Questioned Costs
$1
Year
2022
Accepted
2023-03-08
Audit: 31229
Organization: Wilkes County, North Carolina (NC)
Auditor: Martin Starnes & Associates CPAS P A

AI Summary

  • Core Issue: One casefile had discrepancies between documented resources and supporting documents, but the participant remained eligible for Medicaid.
  • Impacted Requirements: Compliance with 42 CFR 435 and 2 CFR 200 regarding eligibility documentation and internal control procedures.
  • Recommended Follow-Up: Caseworkers need to ensure all eligibility documentation is complete and accurate to prevent future discrepancies.

Finding Text

Internal Control, Significant Deficiency Criteria: In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a recipient meets specific eligibility standards, and documentation must be maintained to support those determinations. In accordance with 2 CFR 200, management should have an adequate system of internal control procedures in place to ensure the accuracy of benefits being provided is within program requirements. Management must monitor activities under federal awards to assure compliance with federal requirements. Condition: One casefile had resources documented in NC FAST that did not match supporting source document (AVS). After review of the cases, the participant was found to still be eligible for Medicaid benefits. Context: Of the 615,695 benefit payments valued at $198,332,895, we examined 60 payment records ($70,630 value) and determined that the above condition to one payment (.09% valued at $63). We determined that the one was still eligible after redetermination with the correct documentation. Effect: Participants could receive benefits for which they are not eligible. Cause: Caseworkers did not take proper steps in making sure what was used for eligibility determination was complete and accurate per program guidelines. Questioned Costs: The finding represents an internal control issue; therefore, no questioned costs are applicable. Upon further review, the applicant was still eligible to receive Medicaid benefits. Recommendation: Caseworkers should review their eligibility determinations and ensure all documentation is included and accurate. Views of Responsible Officials and Planned Corrective Action: See Corrective Action Plan submitted with this report.

Categories

Questioned Costs Eligibility Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 34585 2022-001
    Significant Deficiency
  • 34586 2022-001
    Significant Deficiency
  • 34587 2022-001
    Significant Deficiency
  • 34588 2022-001
    Significant Deficiency
  • 34589 2022-002
    Significant Deficiency
  • 611027 2022-001
    Significant Deficiency
  • 611028 2022-001
    Significant Deficiency
  • 611029 2022-001
    Significant Deficiency
  • 611030 2022-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.778 Medical Assistance Program $1.61M
93.658 Foster Care_title IV-E $1.20M
21.027 Coronavirus State and Local Fiscal Recovery Funds $827,249
93.568 Low-Income Home Energy Assistance - Arpa $490,991
93.563 Child Support Enforcement $458,742
20.106 Airport Improvement Program $432,953
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $428,598
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $357,325
93.268 Immunization Cooperative Agreements $292,390
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $283,178
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $204,862
14.228 Community Development Block Grants/state's Program and Non-Entitlement Grants in Hawaii $118,168
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $80,036
93.556 Promoting Safe and Stable Families $77,413
20.106 Airport Improvement Program - Arpa $60,172
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $58,006
93.217 Family Planning_services $41,970
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $41,752
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $41,742
93.659 Adoption Assistance $39,985
93.069 Public Health Emergency Preparedness $36,556
93.991 Preventive Health and Health Services Block Grant $30,608
93.767 Children's Health Insurance Program $28,018
93.645 Stephanie Tubbs Jones Child Welfare Services Program $22,228
93.994 Maternal and Child Health Services Block Grant to the States $20,087
93.667 Social Services Block Grant $15,677
93.568 Low-Income Home Energy Assistance - Arpa Adm $15,454
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $12,675
97.042 Emergency Management Performance Grants $11,068
93.558 Temporary Assistance for Needy Families $6,841
93.568 Low-Income Home Energy Assistance $3,956
93.566 Refugee and Entrant Assistance_state Administered Programs $759
93.977 Preventive Health Services_sexually Transmitted Diseases Control Grants $100
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $50