Finding Text
FINDING 2022-005 Federal program Federal Assistance Listing Number 93.498 U.S. Department of Health and Human Services COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Activities Allowed or Unallowed and Allowable Costs/Cost Principles and Reporting Material Weakness in Internal Control over Compliance and Material Noncompliance Criteria The terms and conditions of the CARES Act Provider Relief Fund (PRF) program state funds are not to be used to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse. Condition During the process of identifying expenses incurred to prevent, prepare for or respond to the coronavirus pandemic, management did not reduce certain costs by estimated cost-based reimbursement to be received from Medicare and included certain cost items reimbursed through the Covid-19 Testing and Mitigation for Rural Health Clinics program (Federal Assistance Listing Number 93.697). Cause Due to the amount of detailed information required to be compiled by management in order to enter data into the PRF reporting portal, management inadvertently did not reduce certain costs by the estimated Medicare cost-based reimbursement and included other cost amounts already reimbursed through the program 93.697. Effect Management included amounts in the PRF reporting portal which were not eligible based on the terms and conditions of the PRF program. Questioned costs Questioned costs amounted to a combined total of $225,556. The amount of $152,991 relates to management not reducing certain costs by its Medicare cost-based reimbursement and was calculated based off the underlying expense detail management used to complete the PRF reporting portal and the estimated Medicare cost-based reimbursement percentage. The remaining amount of $72,565 was noted as already reimbursed through program 93.697 and determined based off the underlying expense detail management used to complete the PRF reporting portal. Perspective/Context Management used an excel workbook to record and track potential eligible amounts to be reported in the PRF reporting portal. Management selected certain cost amounts to include in the reporting portal and inadvertently missed reducing some of these amounts by the estimated Medicare cost-based reimbursement percentage. Additionally, management used the same excel workbook to track cost for program 93.967 and inadvertently included some of these same costs in the PRF reporting portal. The workbook contained other cost amounts that appear to be eligible that were not input into the PRF reporting portal. Recommendation We recommend management contact HRSA to resolve the matter. The Hospital?s tracking workbook has various cost items listed that were not reported in the unreimbursed expenses section of the HRSA PRF reporting form. We suggest management work with HRSA to see if these additional amounts can be used to offset the questioned costs. Additionally, we recommend management review its current internal controls over federal award compliance and revise its processes to ensure that only eligible costs are included in amounts reported. Views of responsible officials and planned corrective actions Management agrees with the noted finding. Management will continue to refine processes to ensure only allowable costs are reported. Additionally, we have other costs in our cost tracking workbook we believe are allowable and sufficient to cover the $225,556 of questioned costs. We had intended to report these in the unreimbursed expenses section of the PRF reporting portal but inadvertently missed inputting them.