Finding Text
US Department of Health and Human Services Passed through the NC Dept. of Health and Human Services Program Name: Medicaid Assistance Program (Medicaid) AL #: 93.778 Finding 2022-01: Significant Deficiency in Internal Control Criteria: Uniform Guidance 2 CFR ? 200.303 requires the non-Federal entity to ?establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award.? Each County in the State is required to submit quarterly reports with the second party review results with a minimum number of second party reviews completed. Condition: The County is required to complete a minimum number of second party reviews and report the results to the State, which is considered a key control over eligibility determination for Medicaid cases. There is incomplete documentation of the minimum 160 cases that County indicated it performed. GK selected a sample of 10 (10%) of the second party reviews from the list of 99 completed reviews provided by the County and determined that there were no errors in the available cases. Questioned Costs: No questioned costs. Context: The County is required to complete at least 16 Adult Medicaid cases and 24 Family/Children Medicaid cases each quarter and send a summarized report to the State, for a total of 160 cases each year. The County was able to provide a list of 99 of these reviews for the audit, which is 62% of the total 160 required. Cause: Due to lack of documentation, we were not able to sample from a complete population of second party reviews. Effect: Although the 10 selected second party reviews appeared to be appropriately performed, we are unable to conclude on the effectiveness of this internal control or compliance with the State quality control requirement to ensure their review findings were appropriate and that corrections were made timely. Identification of repeat finding: This is not a repeat finding. Recommendation: We would recommend the County make a list of each second party review completed, including the case number, program, date of review, whether there were errors to be corrected. Alternatively, we would recommend that the County use the Second Party Review form provided by the State for all cases and retain a copy of the review until the completion of the audit. Views of responsible officials and planned corrective actions: The County agrees with this finding.