Finding 946767 (2022-008)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2022
Accepted
2024-02-23
Audit: 291952
Organization: Anson County (NC)

AI Summary

  • Core Issue: There were significant errors in eligibility determinations, including 9 instances of inaccurate information entry, leading to ineligible applicants receiving benefits.
  • Impacted Requirements: Compliance with 42 CFR 435 and 2 CFR 200 was not met, as proper documentation and internal controls for eligibility determinations were lacking.
  • Recommended Follow-Up: Conduct internal reviews of files, retrain workers on documentation standards, and ensure all eligibility files include necessary verifications and accurate case notes.

Finding Text

US Department of Health and Human Service Passed through the NC Dept of Health and Human Services Finding: 2022-008 NONCOMPLIANCE / SIGNIFICANT DEFICIENCY Eligibility Criteria: Condition: Context: Effect: Cause: Section III - Federal Award Findings and Questioned Costs (continued) AL # 93.778 Recommendation: Files should be reviewed internally to ensure proper documentation is in place for eligibility. Workers should be retrained on what files should contain and the importance of complete and accurate record keeping. We recommend that all files include online verifications, documented resources of income and those amounts agree to information in NC FAST. The results found or documentation made in case notes that clearly indicates what actions were performed and the results of those actions. Inaccurate Information Entry In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a recipient meets specific income standards, and documentation must be maintained to support eligibility determinations. In accordance with 2 CFR 200, management should have an adequate system of internal controls procedures in place to ensure an applicant is properly determined or redetermined for benefits. There were 9 errors discovered during our procedures that inaccurate information was entered when determining eligibility. One applicant received assistance although the family income were above the State provided income Standard. $569.12. This amount was determined by totaling all the aid received by the applicant who was not eligible. Questioned Costs: The County agrees with the finding. See corrective action plan. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2021-009. Views of Responsible Officials and Planned Corrective Actions: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Program Names: Medical Assistance We examined 60 cases from of a total of 402,727 Medicaid claims from the Medicaid beneficiary report provided by NC Department of Health and Human Services to redetermine eligibility. These findings are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which could affect countable resource. Therefore, a participant could have been approved to receive benefits for which they were not eligible.

Categories

Eligibility Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 370323 2022-006
    Significant Deficiency Repeat
  • 370324 2022-007
    Significant Deficiency Repeat
  • 370325 2022-008
    Significant Deficiency Repeat
  • 370326 2022-009
    Significant Deficiency Repeat
  • 370327 2022-010
    Significant Deficiency
  • 946765 2022-006
    Significant Deficiency Repeat
  • 946766 2022-007
    Significant Deficiency Repeat
  • 946768 2022-009
    Significant Deficiency Repeat
  • 946769 2022-010
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.568 Low-Income Home Energy Assistance $1.35M
93.778 Medical Assistance Program $1.05M
93.558 Temporary Assistance for Needy Families $490,137
93.563 Child Support Enforcement $410,156
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $347,306
20.106 Airport Improvement Program $324,197
93.268 Immunization Cooperative Agreements $284,995
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $162,918
93.667 Social Services Block Grant $152,248
20.509 Formula Grants for Rural Areas and Tribal Transit Program $130,759
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $82,785
97.042 Emergency Management Performance Grants $63,047
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $57,716
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $55,540
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $50,795
16.738 Edward Byrne Memorial Justice Assistance Grant Program $36,898
93.991 Preventive Health and Health Services Block Grant $35,565
93.052 National Family Caregiver Support, Title Iii, Part E $31,680
93.069 Public Health Emergency Preparedness $30,387
93.217 Family Planning_services $26,613
93.767 Children's Health Insurance Program $14,064
93.053 Nutrition Services Incentive Program $13,615
93.994 Maternal and Child Health Services Block Grant to the States $12,037
93.659 Adoption Assistance $10,176
93.645 Stephanie Tubbs Jones Child Welfare Services Program $2,174
93.043 Special Programs for the Aging_title Iii, Part D_disease Prevention and Health Promotion Services $1,700
12.401 National Guard Military Operations and Maintenance (o&m) Projects $958
93.556 Promoting Safe and Stable Families $458
93.977 Preventive Health Services_sexually Transmitted Diseases Control Grants $100
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $21
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $16
93.658 Foster Care_title IV-E $-193,220