by Viktoria Sundqvist CTNewsJunkie
The Connecticut Department of Social Services (DSS) failed to report $9.6 million in Medicaid revenue losses, issued benefits to five deceased clients, failed to report 72 data breaches and extended five contracts beyond their eight-year limit without proper justification, a recent audit shows.
The audit by the state Auditors of Public Accounts, covering the fiscal years ending June 2022 and 2023, noted 25 deficiencies in total, where 19 of them were repeat issues from prior audits.
Internal control deficiencies, instances of noncompliance with laws, regulations, or policies and a need for improvement in practices and procedures that warrant management’s attention were highlighted by auditors.
One finding in the audit was that DSS did not properly review and promptly resolve alerts of client deaths during the audited period. Auditors reviewed 10 death alerts of State Supplement clients and found that DSS issued $51,780 in benefits to five residential care facilities on behalf of five deceased clients and $3,556 in State Supplement and $2,249 in SNAP benefits to one deceased client.
Care facilities report deaths to the Social Security Administration, then DSS is alerted by that agency, but has to confirm the death with the Department of Public Health’s office of vital statistics before benefits can be stopped.
“The Department is working with the Department of Public Health to see if we can integrate their Vital Statistics into the system and will find a way to resolve these alerts within 10 days of receiving them,” DSS said in a statement. “The Department is also working to recoup any overpayments that were made to long-term care facilities and is working to pursue any issues related to fraudulent use of benefits.”
On average, the department is able to recoup about $1 million in SNAP benefits per year from deceased individuals, the statement said.
Auditors said they could not determine the timeliness of three loss reports, including $9.6 million in Medicaid revenue losses for noncompliance with Medicaid timely filing requirements, seven loss reports totaling $12,835 or the impact of the 72 data breaches of client protected health and personal information, according to the report.
“DSS experienced revenue losses that it cannot recover,” auditors said in the report.
The audit also points out that the department, which has receivables averaging $994 million, did not perform collection procedures on delinquent accounts and did not write off uncollectible accounts during fiscal years 2022 and 2023.
Auditors also reviewed 15 contracts totaling $99.7 million, and found that five of them were extended beyond the maximum eight years, ranging from 11 to 16 years.
The department should perform its own periodic audits of administrative functions, strengthen internal controls over Medicaid program integrity, promptly notify auditors and the state comptroller of any breach in security or loss of state funds and strengthen internal controls to ensure all reported accounts receivables are complete and accurate, auditors recommended in the report.
In its response, the department said it recognizes the issues in the audit and has taken “significant steps” to address and improve its internal processes, especially when it comes to Medicaid deadlines and revenue losses.
“The Department is confident this finding will not be reported again as it has established better internal controls and monitoring of Medicaid filing deadlines,” DSS said in a statement issued this week. “Staff training is more robust, and it is working closely with the Centers for Medicare and Medicaid Services to address any issues that may impact the timely filing for reimbursement.”
In terms of the data breaches, the department said it maintains a breach tracking log, but determined that not all instances were considered an actual “breach.”
“The Department recognizes that the determination results have not been documented in the tracking document,” it said in its response to the audit. “This will be added to our process moving forward.”
The Department of Social Services plans, develops, administers, operates, evaluates and provides funding for services and collaborates with other social service agencies to develop and fund prevention, intervention and treatment services for people and families in need.
“DSS has a huge budget,” said three Senate Republicans in a joint statement in response to the audit. “The governor needs to get active and direct the agency to make its administrative functions more efficient while strengthening internal controls over the integrity of the Medicaid program.”
State Sens. Jason Perillo, Rob Sampson and Stephen Harding in their statement called the audit “yet another flashing neon sign on how to save overburdened Connecticut taxpayers millions of dollars.”
“Leadership must come from the top,” they said in their statement. “This is a golden opportunity to confront and eliminate wasteful state government spending.”
Republican state Reps. Vincent Candelora and Jay Case said the audit should be a wake-up call for the governor to get his administration in order and for legislative Democrats to take accountability seriously.
Gov. Ned Lamont’s spokesman, Rob Blanchard, said DSS has taken steps to resolve the issues highlighted in the report since this audit was completed for the 2022 and 2023 years.
“The Auditors of Public Accounts spend 14,000 hours every year auditing DSS and DSS takes their recommendations seriously and works to improve its systems,” Blanchard said. “DSS reviews every complaint from the general public and fraud hotline. In addition to recouping funds, the agency is dedicated to finding any fraud, waste, or abuse elsewhere in the system.”
Discover more from InnerCity News
Subscribe to get the latest posts sent to your email.
