Macon County

Criteria: In accordance with 2 CFR 200, management should have an adequate system of internal control procedures in place to ensure that casefile evidence is appropriately updated. In accordance with 45 CFR 435, documentation must be maintained to support eligibility determinations. Condition: When Medicaid staff received the task notification from NC FAST for a transfer-in case, the applicant was no longer a North Carolina resident; therefore, benefits should have been terminated. Context: Of the 212,825 benefit payments valued at $113,872,460, we examined 60 payment records ($25,921 value) and determined that one casefile (2%, valued at $26) should have been terminated. Upon further review the applicant was deemed ineligible to receive benefits, therefore questioned costs were reported. Effect: Applicants could receive benefits for which they are not eligible. Cause: Eligibility was not terminated timely. Identification of a Repeat Finding: This is modified and a repeat of Finding 2024-001 from the immediate previous audit. Questioned Costs: In accordance with 2 CFR 200, auditors are required to report known questioned costs when likely questioned costs are greater than $25,000. Even though the sample results only identified $26 (federal share $23 and state share $3) in questioned costs, if tests were extended to the entire population, questioned costs could exceed $25,000. Recommendation: When task notifications are received in NC FAST, follow-up and perform task on a timely basis. Views of Responsible Officials and Planned Corrective Actions: See Corrective Action Plan submitted with this report.

Criteria: In accordance with 2 CFR 200, management should have an adequate system of internal control procedures in place to ensure that casefile evidence is appropriately updated. In accordance with 45 CFR 435, documentation must be maintained to support eligibility determinations. Condition: The County Department of Social Services transposed a number during the income calculation, resulting in income being calculated incorrectly. Upon further review, the applicant was ultimately eligible. Context: Of the 272,823 benefit payments valued at $108,451,359.92, we examined 60 payment records ($15,489 value) and determined that one casefile (2%) did not have properly calculated income. Upon further review and recalculation, the applicant was deemed eligible. Effect: Casefile did not have correctly calculated income, which could allow benefits to be provided to individuals who are not eligible. Cause: The caseworker transposed a number in the income calculation resulting in an incorrect income amount being calculated. Questioned Costs: None. The finding represents an internal control issue; therefore, no questioned costs are applicable. The County was able to substantiate that the applicant was eligible to receive benefits. Recommendation: Caseworkers should review their eligibility determinations and ensure all information is entered correctly. Calculations should be reviewed for accuracy before approving benefits. Views of Responsible Officials and Planned Corrective Actions: See Corrective Action Plan submitted with this report.

Criteria: Per the North Carolina DSS Crosscutting Requirements compliance supplement, Counties must acquire adequate case documentation to substantiate the claim entry into the NC Fast Enterprise Program Integrity (“EPI”) system. This information includes, but is not limited to, the dates of the overpayment period, documentary evidence to substantiate that an overpayment occurred, such as wage stubs or verification from an employer, other income verification and household composition verification, and the budgets used to compute the amount of the overpayment. Condition: We noted one instance of a Food and Nutrition Services claim entered in EPI where adequate case documentation to substantiate the claim entry was not maintained. The budget calculated during the initial investigation in the claims file does not agree to the amount entered in EPI to be collected on by the County. Context: We sampled 4 claims that were current in the EPI system and noted the above condition in 1 (25%) of the claims tested. To date, the County has reviewed the budget and corrected the amount in EPI system, as well as the casefile. Effect: The County may not have accurate supporting documentation for claims entered in EPI system. There is a risk that claims may not be valid as a result. Cause: Documentation to support a claim entered into EPI was not accurate. Questioned Costs: None. The finding represents an internal control issue. Recommendation: County DSS staff should implement controls to ensure that all documentation is maintained and agrees to what was entered into EPI. Views of Responsible Officials and Planned Corrective Actions: See Corrective Action Plan submitted with this report.

Criteria: In accordance with 2 CFR 200, management should have an adequate system of internal control procedures in place to ensure that casefile evidence is appropriately updated. In accordance with 45 CFR 435, documentation must be maintained to support eligibility determinations. Condition: The County Department of Social Services failed to update bank account ownership information correctly for one applicant. Upon further review, the applicant was ultimately eligible. Context: Of the 240,540 benefit payments valued at $92,375,680, we examined 60 payment records ($13,116 value) and determined that one casefile (2%) did not have properly calculated resources. Upon further review and recalculation, the applicant was deemed eligible. Effect: Casefile did not have properly updated bank account ownership, which could allow benefits to be provided to individuals who are not eligible. Cause: The caseworker did not correctly update the bank account ownership from 50% to 100%. Questioned Costs: None. The finding represents an internal control issue; therefore, no questioned costs are applicable. The County was able to substantiate that the applicant was eligible to receive benefits. Recommendation: Caseworkers should review their eligibility determinations and ensure all information is entered correctly. Calculations should be reviewed for accuracy before approving benefits. Views of Responsible Officials and Planned Corrective Actions: See Corrective Action Plan submitted with this report.

Criteria: In accordance with 2 CFR 200, management should have a system of internal control procedures in place to reduce the likelihood of errors in reporting program income. Condition: The program income report for the first quarter was submitted late. Effect: Lack of proper implementation of internal controls greatly increases the risk of fraudulent activity and can result in improper financial reporting. Cause: Lack of controls over reporting program income. Questioned Costs: None. The finding represents an internal control issue; therefore, no questioned costs are applicable. Recommendation: Management should assess the controls over program income and implement policies and procedures to address those concerns noted above. Views of Responsible Officials and Planned Corrective Actions: Management concurs with this finding. Please refer to the Corrective Action Plan.

GSA_MIGRATION

GSA_MIGRATION

GSA_MIGRATION

GSA_MIGRATION