FAC Explorer

Finding 61624 (2022-003)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2022
Accepted
2023-03-30
Audit: 56992
Organization: Maniilaq Association (AK)
Auditor: Bdo USA LLP

AI Summary

  • Core Issue: The Association failed to provide necessary documentation for patient eligibility under the IHS program, affecting compliance with funding agreement requirements.
  • Impacted Requirements: Documentation of eligibility for patients receiving medical assistance is mandatory, as per IHS funding agreements and Uniform Guidance.
  • Recommended Follow-Up: Implement monthly audits to verify patient eligibility documentation and ensure compliance; collect outstanding balances if eligibility is not confirmed.

Finding Text

Finding 2022-003 Eligibility ? Noncompliance and Significant Deficiency in Internal Control Over Compliance Agency U.S. Department of Health and Human Services Program Tribal Self-Governance Program: IHS Compacts/Funding Agreements Assistance Listing: No. 93.210 Award No. 58G950028 Year 2022 Criteria or Specific Requirement In accordance with the IHS funding agreement requirements, as well as Uniform Guidance compliance requirements, the Association is required to maintain documentation of eligibility for the patients receiving medical assistance under the IHS program. Condition The Association was unable to provide proper documentation regarding eligibility of some of the patients for which their accounts were adjusted to the IHS compact. Cause COVID-19 pandemic disrupted established processes. Effect or potential effect Individuals may receive services funded by the IHS program who are ineligible to receive these benefits. Questioned Costs Unknown Context We tested 40 patients who were designated as IHS beneficiaries. For 8 of those patients documentation proving eligibility was not on file. Identification as a repeat finding Was reported as finding 2021-002. Recommendation For all patients receiving services, verification of eligibility should be documented and kept on file electronically. If eligibility documentation is not provided, the hospital needs to attempt to collect on the outstanding balance from the individual or insurance companies, rather than adjusting as an IHS beneficiary. Views of Responsible Official and Planned Corrective Action Management agrees with finding. Monthly audits of the elements of registration, including documentation of beneficiary status will be conducted to ensure continual compliance.

Corrective Action Plan

Finding 2022-003 Eligibility - Noncompliance and Significant Deficiency in Internal Control Over Compliance Planned Corrective Actions: Historical documentation on patient eligibility for IHS beneficiary status residing in paper financial files (in use at the time of roll and scroll registration) will be scanned in the BMW registration system making them a permanent part of the patients? electronic health record. Registration staff is requesting beneficiary identification at the time of registration for all patients that do not have it in their EHR. Project is ongoing. Monthly audits of the elements of registration, including documentation of beneficiary status will be conducted to ensure continual compliance. Individual(s) Responsible for Corrective Action Plan Kandy Barlow VP of Health Services 907-442-7385 Anticipated Completion Date: March 31, 2023

Categories

Eligibility Significant Deficiency

Other Findings in this Audit

  • 61622 2022-004
    Significant Deficiency
  • 61623 2022-004
    Significant Deficiency
  • 61625 2022-003
    Significant Deficiency Repeat
  • 61626 2022-003
    Significant Deficiency Repeat
  • 61627 2022-003
    Significant Deficiency Repeat
  • 638064 2022-004
    Significant Deficiency
  • 638065 2022-004
    Significant Deficiency
  • 638066 2022-003
    Significant Deficiency Repeat
  • 638067 2022-003
    Significant Deficiency Repeat
  • 638068 2022-003
    Significant Deficiency Repeat
  • 638069 2022-003
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
15.U02 477 Cluster $2.74M
21.019 Coronavirus Relief Fund $2.56M
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $2.27M
15.022 Tribal Self-Governance $941,294
93.237 Special Diabetes Program for Indians_diabetes Prevention and Treatment Projects $726,688
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $579,421
93.441 Indian Self-Determination $553,011
93.104 Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (sed) $542,899
16.841 Voca Tribal Victim Services Set-Aside Program $488,004
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $443,637
32.006 Covid-19 Telehealth Program $428,398
84.356 Alaska Native Educational Programs $293,349
84.250 American Indian Vocational Rehabilitation Services $284,601
93.788 Opioid Str $248,123
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $236,461
93.671 Family Violence Prevention and Services/domestic Violence Shelter and Supportive Services $214,111
93.047 Special Programs for the Aging_title Vi, Part A, Grants to Indian Tribes_part B, Grants to Native Hawaiians $206,670
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $190,372
16.608 Tribal Court Assistance Program $163,399
66.202 Congressionally Mandated Projects $132,362
16.024 Tribal Sexual Assault Services Program $120,493
93.558 Temporary Assistance for Needy Families $114,672
16.710 Public Safety Partnership and Community Policing Grants $110,779
93.284 Injury Prevention Program for American Indians and Alaskan Natives_cooperative Agreements $100,843
16.587 Violence Against Women Discretionary Grants for Indian Tribal Governments $97,434
93.665 Emergency Grants to Address Mental and Substance Use Disorders During Covid-19 $93,055
66.926 Indian Environmental General Assistance Program (gap) $92,321
93.772 Tribal Public Health Capacity Building and Quality Improvement Umbrella Cooperative Agreement $75,000
93.242 Mental Health Research Grants $73,304
93.479 Good Health and Wellness in Indian Country (a) $72,032
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $65,499
66.817 State and Tribal Response Program Grants $53,669
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $52,969
93.959 Block Grants for Prevention and Treatment of Substance Abuse $45,753
93.210 Tribal Self-Governance Program: Ihs Compacts/funding Agreements $43,177
93.645 Stephanie Tubbs Jones Child Welfare Services Program $40,788
93.498 Provider Relief Fund $36,101
93.556 Promoting Safe and Stable Families $32,726
10.760 Water and Waste Disposal Systems for Rural Communities $24,715
93.658 Foster Care_title IV-E $19,464
16.589 Rural Domestic Violence, Dating Violence, Sexual Assault, and Stalking Assistance Program $16,282
93.U01 Training Assistance Program $11,082
10.762 Solid Waste Management Grants $10,531
93.301 Small Rural Hospital Improvement Grant Program $10,313
15.643 Alaska Migratory Bird CO-Management Council $5,967
93.738 Pphf: Racial and Ethnic Approaches to Community Health Program Financed Solely by Public Prevention and Health Funds $3,561
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nations Health $463