Finding Text
US Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medicaid Assistance Program (Medicaid; Title XIX)
CFDA# 93.778
Finding 2022-006 IV-D Cooperation with Child Support
SIGNIFICANT DEFICIENCY
Eligibility
Section III. Federal Award Findings
Schedule of Findings and Questioned Costs
For the Year Ended June 30, 2022
NORTHAMPTON COUNTY, NORTH CAROLINA
Criteria: In accordance with the Medicaid Manual MA-3365, all Medicaid cases should be evaluated and refered
to the Child Support Enforcement Agency (IV-D). The Child Support Enforcement Agency (IV-D) can assist the
family in obtaining financial and/or medical support or medical support payments from the child’s non-custodial
parent. Cooperation requirement with Social Services and Child Support Agencies must be met or good cause for
not cooperating must be established when determine Medicaid eligibility.
Context: We examined 60 cases from of a total of 255,485 Medicaid claims from the Medicaid beneficiary report
provided by NC Department of Health and Human Services to re-determine eligibility. These findings are being
reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit.
Questioned Costs: There was no known affect to eligibility and there were no known questioned costs.
Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2021-006.
Condition: There were 8 errors discovered during our procedures that referrals between DSS and Child Support
Agencies were not properly made.
Effect: For those certifications/re-certifications there was a chance that information was not properly documented
and reconciled to NC FAST and a participant could have been approved for benefits for which they were not
eligible.
Cause: Human error in reading the ACTS report and/or ineffective case review process.
Recommendation: Files should be reviewed internally to ensure proper information is in place and necessary
procedures are taken when determine eligibility. The results found or documentation made in case notes should
clearly indicate what actions were performed and the results of those actions.
Views of responsible officials and planned corrective actions: The County agrees with the finding. See
Corrective Action Plan.