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)
AL # 93.778
Finding: 2023-002 IV-D Cooperation with Child Support
SIGNIFICANT DEFICENCY
Eligibility
Criteria:
Section III - Federal Award Findings and Questioned Costs
The County's management and other users of the financial statements do not have accurate
information for decisions-making and monitoring of the county's financial position and
adherence to laws, regulations, and other requirements. Errors in financial reporting could
occur and not be detected.
County records were not reconciled properly.
The County should review the ledger and financial documents regularly to ensure that
necessary adjustments are made timely during the year. If information is required from
outside parties, be sure to request this information in time to make an necessary
adjustments.
The County agrees with this finding. Please refer to the corrective action plan for details.
Section II - Financial Statement Findings
Management should have a system in place to verify that transactions are recorded in
correctly, thereby reducing the likelihood of errors in financial reporting.
Prior period adjustments were made to the General Fund that decreased fund balance by
$13,188. These adjustment were to record a correction to forfeiture funds that were received
which had been deposited into the Forfeiture - Treasury checking account, which should
have been deposited into the Forfeiture - Department of Justice account.
In accordance with the Medicaid Manual MA-3365, all Medicaid cases should be evaluated
and referred 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 determining Medicaid eligibility.
Condition:
Questioned Cost:
Context:
Effect:
Identification of a repeat
finding:
Cause:
Recommendation:
Views of responsible
officials and planned
corrective actions:
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)
AL # 93.778
Finding: 2023-003 Inaccurate Resources Entry
SIGNIFICANT DEFICENCY
Eligibility
Criteria:
Section III - Federal Award Findings and Questioned Costs (Continued)
The County agrees with the finding.
In accordance with Medicaid Manual MA-2230, Medicaid for Aged, Blind and Disabled
case records should contain documentation that verifications were done in preparation of
the application and these items will agree to reports in the NC FAST system. In this
process, the countable resources should be calculated correctly and agree back to the
amounts in the NC FAST system. Any items discovered in the verification process should
be considered countable or noncountable resources and explained within the
documentation.
There were 6 errors discovered during our procedures that referrals between the County's
Department of Social Services and Child Support Agencies were not properly made.
For those certifications/re-certifications there was a chance that information was not
properly documented and reconciled to North Carolina Families Accessing Services
through Technology (NC FAST) and a participant could have been approved for benefits
for which they were not eligible.
Human error in reading the Automated Collection and Tracking System (ACTS) report
and/or ineffective case review process.
This is a repeat finding from the immediate previous audit, 2022-004.
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.
There was no known affect to eligibility and there were no known questioned costs.
We examined 60 cases from of a total of 552,116 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.