CITY OF CHESAPEAKE

Findings and Questioned Costs ? Major Federal Awards Finding: 2019-001 Program Name: Medicaid Cluster (CFDA # 93.778-CL) Federal Awarding Agency: Department of Health and Human Services (HHS) State Awarding Agency: Virginia Department of Social Services (VDSS) Department: Chesapeake Department of Social Services (the Department) Compliance Requirement: Eligibility Type of Finding: Significant Deficiency; Non-material noncompliance Criteria: Per 42 Code of the Federal Regulation Section 435.10, The City is required to determine applicant and beneficiary eligibility in accordance with eligibility requirements defined in the State approved plan. Statement of Condition: Of the forty (40) beneficiaries that were enrolled in Medicaid and selected for testing, we identified one (1) beneficiary in our testing that was not eligible to receive benefits, and three (3) instances where case files lacked documentation to support the current year?s determination of eligibility. Cause: The primary underlying causes for this finding are due to the increase in cases and requirements related to the Medicaid Expansion program, as well as the recent conversion to electronic case files. Effect or Potential Effect: The City is not in compliance with the Medicaid eligibility compliance requirement. Recommendation: The City should put procedures in place to ensure personnel responsible for verifying the eligibility of Medicaid participants follow all guidelines for ensuring eligibility based on the State?s plan and retain all documentation related to the proof of eligibility within the case files. Questioned Costs: Undeterminable Management?s Response: Eligibility Supervisors will continue to monitor cases and hold monthly meetings to discuss training needs and error types and trends. The Department will utilize its Quality Assurance Team to conduct random case reviews to identify errors and training needs.