Finding 6867 (2023-001)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2023
Accepted
2023-12-29
Audit: 8821
Organization: Duplin County (NC)
Auditor: Rh CPAS PLLC

AI Summary

  • Core Issue: Five technical errors were found where the documentation for Medicaid applications did not match the data in the NC FAST system.
  • Impacted Requirements: Proper verification documentation is required for Aged, Blind, and Disabled cases, and discrepancies can lead to compliance issues.
  • Recommended Follow-Up: Review and correct the documentation process to ensure all verifications align with NC FAST records and complete recertifications on time.

Finding Text

Criteria: Medicaid for Aged, Blind and Disabled case records should contain documentation that verifications were done in preparation of the application/recertification and these items will agree to reports in the NC FAST system. In this process, documentation should be present and agree back to the records in the NC FAST system. Any items discovered in the process should be considered in regards to a specific eligibility requirement and explained within the documentation. Condition: There were five (5) technical errors discovered during our procedures that verifications in the County documentation and the representative data contained in NC FAST were not the same amounts or files containing policy requirements were not properly documented to be considered in compliance with program control requirements. The errors were as follows: One (1) did not have a completed recertification and the case was rolled forward by the system, however no QC noted per review of admin letters. Four (4) recertification procedures were started; however, the case was rolled forward by the system before the recertification was completed. No QCs noted per review of admin letters. Questioned Costs (QC): There was no affect to eligibility and there were no questioned costs.

Corrective Action Plan

FORCED ELIGIBILITY Supervisors/Lead Workers and staff will pull case management reports weekly to ensure all recertifications are actively being completed. Staff will proactively use desk or Microsoft calendar to keep up with all recertifications. Staff will complete refresher courses for timely notices. Supervisors will disburse vacant caseload timely after employee leaves to ensure all recertifications are accounted for, distributed and worked. Supervisors will ensure that staff run eligibility checks even if the recertification is rolled over by the system/state. In an effort to prevent the system from automatically rolling the case over, staff will process (recertify and terminate) all cases by the 8110 cutoff date. Staff will implement these changes for the January 2024 recertification period. Staff will be informed on changes and changes will be implemented on December 4, 2023.

Categories

Eligibility

Other Findings in this Audit

  • 583309 2023-001
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
20.526 Buses and Bus Facilities Formula, Competitive, and Low Or No Emissions Programs $2.42M
93.778 Medical Assistance Program $2.04M
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $881,491
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $766,573
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $698,032
93.563 Child Support Enforcement $645,731
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $482,524
20.509 Formula Grants for Rural Areas and Tribal Transit Program $350,515
93.667 Social Services Block Grant $275,194
93.658 Foster Care_title IV-E $201,378
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $188,471
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $141,429
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $133,570
93.568 Low-Income Home Energy Assistance $102,789
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $94,407
93.268 Covid-19 Cooperative Agreements $85,965
21.027 Coronavirus State and Local Fiscal Recovery Funds $74,375
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $67,980
93.069 Public Health Emergency Preparedness $60,370
93.217 Family Planning_services $54,973
93.767 Children's Health Insurance Program $54,653
16.922 Equitable Sharing Program $50,949
93.994 Maternal and Child Health Services Block Grant to the States $40,674
97.042 Emergency Management Performance Grants $39,032
66.818 Brownfields Assessment and Cleanup Cooperative Agreements $33,691
93.991 Preventive Health and Health Services Block Grant $30,607
93.053 Nutrition Services Incentive Program $25,173
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $24,014
16.606 State Criminal Alien Assistance Program $20,827
93.268 Immunization Cooperative Agreements $17,314
93.558 Temporary Assistance for Needy Families $11,897
93.645 Stephanie Tubbs Jones Child Welfare Services Program $11,338
93.052 National Family Caregiver Support, Title Iii, Part E $10,727
45.313 Laura Bush 21st Century Librarian Program $10,000
97.039 Hazard Mitigation Grant $9,618
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $9,500
45.219 N.c Humanaties Large Grant $7,500
10.923 Emergency Watershed Protection Program $6,718
93.566 Refugee and Entrant Assistance_state Administered Programs $5,973
93.043 Special Programs for the Aging_title Iii, Part D_disease Prevention and Health Promotion Services $4,973
93.071 Medicare Enrollment Assistance Program $4,824
93.659 Adoption Assistance $3,296
93.658 Foster Care $1,782
20.106 Airport Improvement Program $617
93.436 Well-Integrated Screening and Evaluation for Women Across the Nation (wisewoman) $270
93.977 Preventive Health Services_sexually Transmitted Diseases Control Grants $100