Finding 627776 (2022-002)

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

AI Summary

  • Core Issue: Inadequate controls over reporting COVID test kit expenditures led to errors in reimbursement claims, with 6 out of 28 samples showing inaccuracies.
  • Impacted Requirements: The lack of effective internal controls violated 2 CFR 200.303, which mandates compliance with federal laws and program requirements.
  • Recommended Follow-up: Strengthen the management review process to ensure accurate reporting and prevent unallowable costs from being charged to federal programs.

Finding Text

Finding No: 2022-002 Federal Agency: U.S. Department of Health and Human Services Assistance Listing Number: 93.697 Program: COVID- 19 Testing and Mitigation for Rural Health Clinics Compliance Requirement: Activities allowed or unallowed/allowable costs Award Year: January 1, 2021 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. (b) Condition Found The System did not have adequate controls related to reporting of laboratory expenditures specific to the number of COVID test kits. This reporting was utilized to determine the costs allowed for reimbursement under the program, resulting in 6 daily counts out of 28 selected samples containing errors, with a net overstatement of expenses of $2,000. (c) Cause The System?s review process in place over the recording of these costs did not operate effectively to prevent unallowable charges and inaccurate amounts from being submitted for reimbursement by the federal agency. (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 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. (i) View of Responsible Officials The test kit counts for COVID-19 Testing and Mitigation for Rural Health Clinics (CFDA No. 93.697) reporting were generated through daily data analysis reports of Covid positive and negative resulted tests. The number of resulted tests were manually entered into a spreadsheet by lab personnel at North Mississippi Medical Clinics. The spreadsheet was used to assign the costs of the kits to each clinic where the resulted test occurred. Lab personnel did not consistently record accurate counts and did not perform a daily or monthly reconciliation to the generated data reports.

Categories

Allowable Costs / Cost Principles Cash Management Reporting 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
  • 624917 2022-003
    Significant Deficiency
  • 627775 2022-001
    Material Weakness

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