EIN: 810432358
UEI: WQV6F3GXKPR8
Audited by: Baker Tilly US LLP
Oversight agency: 93 [Department of Health and Human Services]
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Data as of September 2, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on June 27, 2025. Under 2 CFR 200.521(d), a pass-through entity that provided federal funds to this organization for this audit period must issue a management decision on these findings by December 27, 2025 (251 days ago).
What is a management decision? →2023-001
FAC accepted this audit on June 27, 2024 — management decision was due December 27, 2024.
2022-001
FAC accepted this audit on June 28, 2023 — management decision was due December 28, 2023.
2021-002
FAC accepted this audit on December 20, 2022 — management decision was due June 20, 2023.
Criteria ? In accordance with the Tribe?s Annual Funding Agreement with the Department of Health and Human Services, Indian Health Service eligibility regulations require that grantees verify eligibility before providing services and maintain records documenting such eligibility. Condition and context ? The Tribe?s Indian Self-Determination program is used to provide quality health services through direct, referral, and contract services, to include the newly added Tribal Premium Sponsorship Program (TPSP). TPSP provides insurance benefits for eligible beneficiaries. To be considered eligible for these benefits, potential enrollees must be an American Indian and reside within the Contract Health Service Delivery Area (CHSDA) who are Purchased/Referred Care (PRC) eligible and lack comprehensive health insurance coverage. Out of 25 participants tested for the TPSP program we found the following: ? There was no documentation for 24 participants verifying their physical residency within the CHSDA as per PRC guidelines. ? Two participant files were missing proof of authorization from the program director prior to enrollment. The participant was also found to not have documentation verifying their physical residency within the CHSDA as per PRC guidelines. Cause ? The Tribe?s TPSP staff did not obtain and retain specific documents for patients to document eligibility prior to providing services. Effect ? Individuals that are not eligible to receive services may have received services. Questioned costs ? It is unknown what services the Clinic may have provided to an ineligible person and at what cost, and if that amount that may have been expended can be determined, as such the questioned costs are unknown. Repeat finding ? This was previously reported as finding 2020-004. Recommendation ? We recommend the Tribe?s TPSP management re-evaluate processes and controls over participant eligibility, including ensuring that documentation to support and verify physical residency is retained for all participants, regardless of whether the program staff are familiar with the participant or not. Views of responsible officials ? The program will be reviewing its procedures to ensure that documentation of participants are centralized and maintained in participant files.
Show full finding ▾Hide full finding ▴Criteria ? In accordance with the Tribe?s Annual Funding Agreement with the Department of Health and Human Services, Indian Health Service eligibility regulations require that grantees verify eligibility before providing services and maintain records documenting such eligibility. Condition and context ? The Tribe?s Indian Self-Determination program is used to provide quality health services through direct, referral, and contract services, to include the newly added Tribal Premium Sponsorship Program (TPSP). TPSP provides insurance benefits for eligible beneficiaries. To be considered eligible for these benefits, potential enrollees must be an American Indian and reside within the Contract Health Service Delivery Area (CHSDA) who are Purchased/Referred Care (PRC) eligible and lack comprehensive health insurance coverage. Out of 25 participants tested for the TPSP program we found the following: ? There was no documentation for 24 participants verifying their physical residency within the CHSDA as per PRC guidelines. ? Two participant files were missing proof of authorization from the program director prior to enrollment. The participant was also found to not have documentation verifying their physical residency within the CHSDA as per PRC guidelines. Cause ? The Tribe?s TPSP staff did not obtain and retain specific documents for patients to document eligibility prior to providing services. Effect ? Individuals that are not eligible to receive services may have received services. Questioned costs ? It is unknown what services the Clinic may have provided to an ineligible person and at what cost, and if that amount that may have been expended can be determined, as such the questioned costs are unknown. Repeat finding ? This was previously reported as finding 2020-004. Recommendation ? We recommend the Tribe?s TPSP management re-evaluate processes and controls over participant eligibility, including ensuring that documentation to support and verify physical residency is retained for all participants, regardless of whether the program staff are familiar with the participant or not. Views of responsible officials ? The program will be reviewing its procedures to ensure that documentation of participants are centralized and maintained in participant files.
The Tribe has communicated with the Tribe?s Tribal Health Program, TPSP management on training personnel on the processes and controls over participant eligibility. The Tribe is working on obtaining the appropriate documentation to support and verify physical residency is retained for participants. The NCTBOH is currently updating policies with tribal attorney to mitigate future findings. Persons responsible - Serena Wetherelt, President and Kayla Grinsell, Tribal Health Administrator Estimated completion date - September 30, 2023
2020-004
FAC accepted this audit on August 11, 2022 — management decision was due February 11, 2023.
FAC accepted this audit on March 24, 2022 — management decision was due September 24, 2022.
2018-001
2018-002
FAC accepted this audit on June 30, 2019 — management decision was due December 30, 2019.
GSA_MIGRATION
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GSA_MIGRATION
2017-001
GSA_MIGRATION
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GSA_MIGRATION
FAC accepted this audit on June 28, 2018 — management decision was due December 28, 2018.
GSA_MIGRATION
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GSA_MIGRATION
2016-001
FAC accepted this audit on June 28, 2017 — management decision was due December 28, 2017.
GSA_MIGRATION
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GSA_MIGRATION
2015-001
Data source: This information comes from the Federal Audit Clearinghouse, the official repository of Single Audit data. All data is public domain. Verify this organization's audit history at fac.gov.
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