Finding 624917 (2022-003)

Significant Deficiency
Requirement
AB
Questioned Costs
-
Year
2022
Accepted
2023-09-27
Audit: 53146
Auditor: Kpmg LLP

AI Summary

  • Core Issue: Inadequate controls in the reporting process for the HIV Care Formula Grant led to incorrect billing, including duplicate charges.
  • Impacted Requirements: Compliance with 2 CFR 200.303 was not met, as internal controls failed to ensure accurate reporting of federal expenditures.
  • Recommended Follow-Up: Strengthen the management review process to prevent future inaccuracies and ensure all charges are properly assessed before submission.

Finding Text

Finding No: 2022-003 Federal Agency: U.S. Department of Health and Human Services Assistance Listing Number: 93.917 Program: HIV Care Formula Grants Compliance Requirement: Activities allowed or unallowed/allowable costs Award Year: January 1, 2022 through December 31, 2022 (a) Criteria or Requirement 2 CFR 200.303 requires non-federal entities receiving federal awards to establish and maintain internal controls designed to reasonably ensure compliance with federal laws, regulations, and program compliance requirements. Effective internal control should include procedures to ensure federal expenditures are accurately and completely reported on the SEFA. (b) Condition Found The System did not have adequate controls related to reporting expenditures for the HIV Care Formula Grant. Our testing identified 3 charges out of a sample of 43 that had been billed incorrectly to the granting agency. These charges were all for HIV-related care, consistent with the grant agreement, but were duplicate charges or other adjustments made to the billings that should have been adjusted prior to submission to the federal agency. (c) Cause The System has a review process in place to review all requests for reimbursement to the federal agency, including having a specific employee review all of these charges during the year. During the 2022 fiscal year, there was turnover within this position, resulting in an ineffective operation of the controls in place. (d) Effect Federal funds were expended for unallowable purposes or for inaccurate amounts and evidence of the effective operation of management review controls was not maintained in accordance with Federal requirements. (e) Questioned Cost None reportable (f) Statistical Sample Not applicable (g) Repeat Finding in the Prior Year Not a repeat finding (h) Recommendation (i) We recommend that the System strengthen controls over the management review process to prevent unallowable costs and inaccurate amounts from being charged to Federal programs. (j) View of Responsible Officials Invoices submitted to Mississippi State Department of Health (MSDH) for the HIV Care Formula Grants (CFDA No. 93.917) were reviewed by the clinic office manager prior to submission. There was no adequate assessment of all applicable patient charges in the invoice to MSDH. Of the 43 samples chosen for FY2022, there were 3 charges that were incorrectly submitted on an invoice to MSDH for reimbursement.

Categories

Allowable Costs / Cost Principles Reporting Cash Management Matching / Level of Effort / Earmarking

Other Findings in this Audit

  • 48475 2022-003
    Significant Deficiency
  • 51333 2022-001
    Material Weakness
  • 51334 2022-002
    Significant Deficiency
  • 627775 2022-001
    Material Weakness
  • 627776 2022-002
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $10.83M
93.461 Covid-19 Testing for the Uninsured $1.22M
93.155 Rural Health Research Centers $898,116
93.247 Advanced Nursing Education Grant Program $894,354
93.697 Covid-19 Testing for Rural Health Clinics $794,625
93.917 Hiv Care Formula Grants $790,654
21.027 Coronavirus State and Local Fiscal Recovery Funds $662,852
32.006 Covid-19 Telehealth Program $259,900
93.301 Small Rural Hospital Improvement Grant Program $26,139
93.889 National Bioterrorism Hospital Preparedness Program $8,583