FINANCIAL AUDIT OF THE DEPARTMENT OF HUMAN SERVICES STATE OF HAWAII Fiscal Year Ended June 30, 2009_part9 potx

End Date: DHS budget request to the 2010 Legislature. However, the MOD intends to submit a request to hire for this position. Also impacting the resources required to address these recommendations are similar vacant positions frozen and offered for abolishment in the MOD Systems Office (SO). These SO positions are required to assist with developing HPMMIS reports for SURS analysis. In spite of all the shortcomings, the MOD is currently in the testing stage of using a Data Storage Warehouse. Once testing is completed and training is done, the MOD will be able to produce its own reports and not have to rely on other resources for those reports. The MOD is a part of an RFP released by the state of Arizona's Medicaid program (AHCCCS) to obtain a SURS subsystem for use with the Data Storage Warehouse. This subsystem will enable the MOD to use pre-set algorithms to obtain reports. It is not known when human resources will be restored to the full and necessary MOD staffing to allow the program to meet the compliance requirements in this important area, and we understand that this is due to the unprecedented statewide budget shortfall. Ongoing Responding Person: Ann Kinningham, MOD Finance Officer Phone: (808) 692-7956 Ref. No. 2009-06 Auditor's Recommendation: Corrective Action Taken or Planned: Complete Eligibility Applications and Annual Eligibility Re- verifications in a Timely Manner The DHS should assess the staffing requirements at the MOD Eligibility Branch and make every effort to eliminate the backlog of applications pending eligibility determinations and perform timely annual Je-verifications as required by federal regulations in order to reduce the risk that ineligible recipients are receiving Medicaid benefits. The MOD is keenly aware of the staffing shortages in the Eligibility Branch as a result of the hiring freeze, Reduction in Force (RIF), and budget requests to abolish the RIF and vacant positions. These staffing shortfalls have affected the Branch's ability to perform timely eligibility application determinations and annual re-determinations as reqUired by federal regulations. Prior to these events, with implementation of new workflow processes, the backlog was decreased by more than 50% while at the same time new enrollment increased by a record 13%. An eligibility calculator is under development that will improve the 89 This is trial version www.adultpdf.com End Date: accuracy and efficiency of eligibility determinations, and a reorganization to develop a new eligibility division with substantial efficiencies has been proposed. Ongoing Responding Person: Ann H. Kinningham, MOD Finance Officer Phone: (808) 692-7956 Ref. No. 2009-07 Auditor's Recommendation: Corrective Action Taken or Planned: End Date: Monitor the Medicaid Drug Rebate Program The DHS should establish formal procedures to monitor its subcontractor to. ensure the drug rebate program operates in compliance with CMS guidelines and help identify issues timely. In addition, the DHS should resolve outstanding issues on a timely basis. The MOD acknowledges the problems resulting from its previous contractor implementing the initial drug rebate program during the period 1991 ; 2001. Significant efforts have been made to seek drug manufacturers input and corrections to the questionable accounts receivable ledgers in the past six months. A fin.al report has been submitted to the CMS and is currently under review. Procedures have been developed and issued to the current fiscal agent. With the implementation of QUEST Expanded Access, the volume of prescription drug claims has decreased substantially. Ongoing Responding Person: Ann Kinningham, MOD Finance Officer Phone: (808) 692-7956 Ref. No. 2009·08 Auditor's Recommendation: Corrective Actions Taken or Planned: Maintain All Required Documentation In Child Care Case Flies The DHS should ensure that required documents are maintained in each case file to support the allowability and eligibility of the child care payments claimed for federal reimbursement. The DHS should perform secondary reviews on a sample basis in order to assess case manager performance. We have discussed this issue with our Staff Development Office which is responsible to provide training to all staff who issue child care payments. They will continue to emphasize the need to maintain appropriate documentation in the case record. Random cases are now reviewed monthly to determine that payments issued were properly authorized. DHS will continue this practice as it has been helpful in determining on-going 90 This is trial version www.adultpdf.com End Date: training needs as well as worker performance. Ongoing Responding Person: Julie Morita, BESSO CCP Administrator Phone (808) 586-7187 Ref. No. 2009-09 Auditor's Recommendation: Corrective Action Taken or Planned: End Date: Improve the Accuracy of Child Care Reimbursement The OHS should ensure that reimbursements to child care program participants are calculated properly. The OHS should perform post payment reviews of a sample of child care payments to ensure accuracy and assess case worker performance. Random cases are now reviewed monthly to determine that correct payments were issued. OHS will continue this practice as it has been helpful in determining on-going training needs as well as worker performance. Ongoing Responding Person: Julie Morita, BESSO CCP Administrator Phone (808) 586-7187 91 This is trial version www.adultpdf.com . End Date: DHS budget request to the 2010 Legislature. However, the MOD intends to submit a request to hire for this position. Also impacting the resources required to address these recommendations are similar vacant positions frozen and offered for abolishment in the MOD Systems Office (SO). These SO positions are required to assist with developing HPMMIS reports for SURS analysis. In spite of all the shortcomings, the MOD is currently in the testing stage of using a Data Storage Warehouse. Once testing is completed and training is done, the MOD will be able to produce its own reports and not have to rely on other resources for those reports. The MOD is a. End Date: DHS budget request to the 2010 Legislature. However, the MOD intends to submit a request to hire for this position. Also impacting the resources required to address these recommendations are similar vacant positions frozen and offered for abolishment in the MOD Systems Office (SO). These SO positions are required to assist with developing HPMMIS reports for SURS analysis. In spite of all the shortcomings, the MOD is currently in the testing stage of using a Data Storage Warehouse. Once testing is completed and training is done, the MOD will be able to produce its own reports and not have to rely on other resources for those reports. The MOD is a part of an RFP released by the state of Arizona's Medicaid program (AHCCCS) to obtain a SURS subsystem for use with the Data Storage Warehouse. This subsystem will enable the MOD to use pre-set algorithms to obtain reports. It is not known when human resources will be restored to the full and necessary MOD staffing. Manner The DHS should assess the staffing requirements at the MOD Eligibility Branch and make every effort to eliminate the backlog of applications pending eligibility determinations and perform timely annual Je-verifications as required by federal regulations in order to reduce the risk that ineligible recipients are receiving Medicaid benefits. The MOD is keenly aware of the staffing shortages in the Eligibility Branch as a result of the hiring freeze, Reduction in Force (RIF), and budget requests to abolish the RIF and vacant positions. These staffing