FAC Explorer

Finding 627444 (2022-002)

Material Weakness Repeat Finding
Requirement
E
Questioned Costs
$1
Year
2022
Accepted
2022-12-08
Audit: 45126
Organization: Union County (NC)
Auditor: Cherry Bekaert LLP

AI Summary

  • Core Issue: The County lacks adequate documentation for eligibility determinations in the Medical Assistance program, leading to errors in participant eligibility.
  • Impacted Requirements: Key compliance criteria were not met, including verification of self-attest wages, household counts, citizenship status, and property ownership.
  • Recommended Follow-Up: The County should enhance documentation processes, provide caseworker training, increase quality reviews, and address staffing shortages in the Medicaid units.

Finding Text

U.S. Department of Health and Human Services Passed through the North Carolina Department of Health and Human Services Program Name: Medical Assistance Federal Assistance Listing Number: 93.778 Material Weakness and Nonmaterial Noncompliance ? Eligibility Finding 2022-002 ? Repeat Finding Criteria or Specific Requirement: The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NC FAST. We noted several errors related to the following compliance criteria: a) At the time of each initial application or annual redetermination of benefits for Medical Assistance, self-attest wages should be verified, documented, and entered correctly into the budget in order to determine if the participant is eligible to receive benefits. b) At the time of each initial application or annual redetermination of benefits for Medical Assistance, the household count documented in NC FAST should be agreed to supporting documentation. c) At the time of each initial application or annual redetermination of benefits for Medical Assistance, either citizenship/identity documentation or alien status documentation (if non-citizen) existed in NC FAST. d) At the time of each initial application or annual redetermination of benefits for Medical Assistance, the caseworker should review the Register of Deeds for aged, blind, or disabled cases, or for MQB program cases, to verify property owned by the participant and this information should be entered into the NC FAST system. Condition: The following are the results for each criteria listed above out of the 60 program participants selected for testing: a) There were two instances where there was a computation error for income reported in NC FAST. b) There was one instance where the supporting documentation related to household count did not support the information entered into NC FAST. c) There was one instances where citizenship was not verified. d) There was one instance where the Register of Deeds was not run. Context: We sampled 60 cases from a total population of 40,798 cases made to the participants during the fiscal year. There were 5 out of 60 unique participants tested with the errors noted above, in which one was determined to have been improperly determined eligible. Questioned Costs: We noted a total of $8,215 in questioned costs related to improper eligibility determination related to item ?c? noted above. Total claims tested totaled $1,803,371 and so the projected questioned costs were a calculated 0.84% error rate. Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk the County could provide funding to individuals who are not eligible. Cause: County oversight when performing eligibility determinations. Recommendation: The County should review their processes to ensure proper supporting documentation of eligibility is maintained within each case file, caseworkers have proper training, and the number of quality reviews is sufficient. Additionally, the County should continue to work toward filling vacancies in the Family and Children?s Medicaid Units. Views of responsible officials: Management agrees with the finding and is implementing procedures to correct this which is further discussed in the corrective action plan. Corrective Action Plan: See Corrective Action Plan prepared by the County.

Categories

Questioned Costs Eligibility Material Weakness Internal Control / Segregation of Duties

Other Findings in this Audit

  • 50981 2022-003
    Significant Deficiency
  • 50982 2022-003
    Significant Deficiency
  • 50983 2022-003
    Significant Deficiency
  • 50984 2022-003
    Significant Deficiency
  • 50985 2022-003
    Significant Deficiency
  • 50986 2022-003
    Significant Deficiency
  • 50987 2022-003
    Significant Deficiency
  • 50988 2022-003
    Significant Deficiency
  • 50989 2022-002
    Material Weakness Repeat
  • 50990 2022-003
    Significant Deficiency
  • 50991 2022-003
    Significant Deficiency
  • 50992 2022-003
    Significant Deficiency
  • 50993 2022-003
    Significant Deficiency
  • 50994 2022-003
    Significant Deficiency
  • 50995 2022-003
    Significant Deficiency
  • 50996 2022-002
    Material Weakness Repeat
  • 50997 2022-003
    Significant Deficiency
  • 50998 2022-002
    Material Weakness Repeat
  • 50999 2022-003
    Significant Deficiency
  • 51000 2022-002
    Material Weakness Repeat
  • 51001 2022-003
    Significant Deficiency
  • 51002 2022-002
    Material Weakness Repeat
  • 51003 2022-003
    Significant Deficiency
  • 51004 2022-002
    Material Weakness Repeat
  • 51005 2022-003
    Significant Deficiency
  • 51006 2022-002
    Material Weakness Repeat
  • 51007 2022-003
    Significant Deficiency
  • 51008 2022-002
    Material Weakness Repeat
  • 51009 2022-003
    Significant Deficiency
  • 51010 2022-002
    Material Weakness Repeat
  • 51011 2022-003
    Significant Deficiency
  • 51012 2022-002
    Material Weakness Repeat
  • 51013 2022-003
    Significant Deficiency
  • 627423 2022-003
    Significant Deficiency
  • 627424 2022-003
    Significant Deficiency
  • 627425 2022-003
    Significant Deficiency
  • 627426 2022-003
    Significant Deficiency
  • 627427 2022-003
    Significant Deficiency
  • 627428 2022-003
    Significant Deficiency
  • 627429 2022-003
    Significant Deficiency
  • 627430 2022-003
    Significant Deficiency
  • 627431 2022-002
    Material Weakness Repeat
  • 627432 2022-003
    Significant Deficiency
  • 627433 2022-003
    Significant Deficiency
  • 627434 2022-003
    Significant Deficiency
  • 627435 2022-003
    Significant Deficiency
  • 627436 2022-003
    Significant Deficiency
  • 627437 2022-003
    Significant Deficiency
  • 627438 2022-002
    Material Weakness Repeat
  • 627439 2022-003
    Significant Deficiency
  • 627440 2022-002
    Material Weakness Repeat
  • 627441 2022-003
    Significant Deficiency
  • 627442 2022-002
    Material Weakness Repeat
  • 627443 2022-003
    Significant Deficiency
  • 627445 2022-003
    Significant Deficiency
  • 627446 2022-002
    Material Weakness Repeat
  • 627447 2022-003
    Significant Deficiency
  • 627448 2022-002
    Material Weakness Repeat
  • 627449 2022-003
    Significant Deficiency
  • 627450 2022-002
    Material Weakness Repeat
  • 627451 2022-003
    Significant Deficiency
  • 627452 2022-002
    Material Weakness Repeat
  • 627453 2022-003
    Significant Deficiency
  • 627454 2022-002
    Material Weakness Repeat
  • 627455 2022-003
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.563 Child Support Enforcement $1.33M
21.027 Coronavirus State and Local Fiscal Recovery Funds $1.26M
93.568 Low-Income Home Energy Assistance $812,488
14.218 Community Development Block Grants/entitlement Grants $514,652
93.667 Social Services Block Grant $481,860
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $442,477
21.023 Emergency Rental Assistance Program $403,221
20.507 Federal Transit_formula Grants $309,598
93.767 Children's Health Insurance Program $184,174
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $170,470
20.600 State and Community Highway Safety $167,616
93.658 Foster Care_title IV-E $167,183
21.019 Coronavirus Relief Fund $164,233
97.042 Emergency Management Performance Grants $101,622
20.513 Enhanced Mobility of Seniors and Individuals with Disabilities $99,961
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $85,194
10.923 Emergency Watershed Protection Program $78,853
93.217 Family Planning_services $75,459
93.556 Promoting Safe and Stable Families $53,859
93.645 Stephanie Tubbs Jones Child Welfare Services Program $48,576
16.034 Coronavirus Emergency Supplemental Funding Program $47,067
20.505 Metropolitan Transportation Planning and State and Non-Metropolitan Planning and Research $43,956
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $39,042
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $37,798
93.991 Preventive Health and Health Services Block Grant $33,956
20.509 Formula Grants for Rural Areas and Tribal Transit Program $29,819
93.499 Low Income Household Water Assistance Program $28,904
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $26,443
93.053 Nutrition Services Incentive Program $25,052
93.558 Temporary Assistance for Needy Families $16,141
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $10,466
93.566 Refugee and Entrant Assistance_state Administered Programs $8,329
93.659 Adoption Assistance $6,850
93.778 Medical Assistance Program $6,230
93.074 Hospital Preparedness Program (hpp) and Public Health Emergency Preparedness (phep) Aligned Cooperative Agreements $4,295
93.268 Immunization Cooperative Agreements $3,103
10.551 Supplemental Nutrition Assistance Program $1,491
93.994 Maternal and Child Health Services Block Grant to the States $1,472
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $975
93.977 Preventive Health Services_sexually Transmitted Diseases Control Grants $158
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $79