Institutional Federal Compliance Report 2021

STATE OF NEW YORK

Schedule of Findings and Questioned Costs

Year ended March 31, 2018

Federal Agency:

U.S. Department of Health and Human Services

Federal Program:

Children’s Health Insurance Program (93.767)

Federal Award Numbers:

1605NY5021, 1705NY0301, 1705NY5021, and 1805NY5021

Federal Award Years:

2016 and 2017

State Agency:

Department of Health

Reference:

2018-036

Criteria Title 45 U.S. Code of Federal Regulations Part 75 (45 CFR 75), Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards section 75.303(a), Internal Controls, states the non-Federal entity must Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. Condition The Department of Health (the Department) did not have a process in place to reconcile the claims reported to the Center for Medicaid Services (CMS) on form CMS 64.21 to the State’s requests for reimbursements for the CHIP program on a timely basis. Cause The condition is due to the Department not having a control designed to reconcile the Form CMS 64.21 to the expenditure records requested for federal reimbursement within the State’s accounting system to a sufficient precision to detect potential noncompliance. The Department’s process is to transfer from Medicaid allowable M-CHIP expansion population (100 – 133% of the Federal Poverty Line) to CHIP prior to claiming the expenditures from CMS. The Department identified during the 2018 State fiscal year approximately $509 million of costs related to the Aliessa-related legal immigrant population whose costs that had been claimed and reported as Children’s Health Insurance Program (CHIP) expenditures on Form CMS 64.21 in the prior years. The Department determined the approximately $509 million based on a comparison of historical form CMS 64.21 reports and Journal Entries processed in the State’s accounting records for prior transfers, beginning in 2011. As the $509 million had been paid in the first instance through Federal Medicaid and has never been moved to the CHIP grant(s) where the associated costs were claimed, the Department processed a Journal Entry during the 2018 State fiscal year transferring the $509 million from its Federal Medicaid grants, to its CHIP Federal Awards. Possible Asserted Effect Failure to request reimbursement of allowable expenditures may result in unallowable costs being reimbursed outside the period of performance and not being allowed for federal reimbursement.

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