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 2023-008 IV-D Cooperation with Child Support
SIGNIFICANT DEFICIENCY
Eligibility
Criteria: 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 determine Medicaid eligibility.
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.