Finding 972275 (2023-006)

Significant Deficiency over Eligibility; Information on the federal programs: Medicaid Cluster (Medicaid), Assistance Listing Number 93.778, U.S. Department of Health and Human Services, passed through the N.C. Department of Health and Human Services (NCDHHS), Division of Social Services (DSS). Criteria: Per the Medicaid and NCHC Eligibility Review Document, the County DSS should send the DMA-5097, Request for Information, to the non-custodial parent after application approval. The beneficiary is allowed 12 calendar days to provide information. The casefile must contain information on the non-custodial parent. If no information is provided on the non-custodial parent, case should terminate by date shown on timely notice. Condition: Each casefile should contain information on the non-custodial parent, requested by the County DSS after the approval of the application. We noted one casefile that did not have information for one of the children. Context/Cause: No child support referral was conducted. We noted the above condition in one of the sixty Medicaid cases selected. Effects: Lack of required support due to County DSS not conducting a timely child support referral could affect the total federal and state reimbursement for the program, as the benefits should have been terminated. Recommendation: We recommend that the County implements a review control over eligibility requirements. Auditee’s Response: We concur with the finding.