Risk & Quality Management Team: Oversight and Monitoring Unit (OMU)

# of overall DVHA audit findings that are repeat audit findings

4SFY 2021

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Notes on Methodology

1. Please note that in the chart above:

  • The solid trendline represents the total # of findings for the SFY
  • The dotted trendline represents the # of repeat finding for the SFY

2. Goal: 

  • The goal for this measure is no repeat findings. However, it is understandable if there are repeat findings related to known or discovered system problems that require ADS project assessment. 

Partners
  • DVHA staff
  • DVHA Unit Directors
  • DVHA Leadership
Story Behind the Curve

This measure is important because DVHA is required to be compliant with all Federal and State policies regarding the administration of the Medicaid Program and the Qualified Health Plans.

When an audit identifies findings, DVHA will work to correct the issue in the approved time frames to ensure there are no repeat findings when that auditor or regulator returns. This measure shows the total number of audit findings in audits that closed during a state fiscal year (SFY) and the percent that are repeat findings from previous audits. The expectation of regulators, auditors and examiners is that findings and recommendations are resolved before the next exam or audit. The State provides corrective action plans (CAPs) to these entities at the close of each audit, as well as periodic progress reports as necessary. Findings and recommendations not adequately addressed before the next audit are reported as repeat findings.

Since 2016, The total number of findings and number of repeat findings have both decreased significantly.

Audits:

45 CFR is an annual audit of the Vermont State Exchange "VHC" by an independent qualified auditing entity.

The Comprehensive Annual Financial Report (CAFR) is a thorough and detailed annual presentation of the state's financial condition. It reports on the state's activities and balances for each fiscal year.

 

The Single Audit is an annual review by the State‚Äôs external audit firm to ensure a recipient of federal funds is in compliance with the federal program's requirements for how the money can be used.

 

CMS PI Review is a periodic audit. On a rotating cycle, the Centers for Medicare & Medicaid Services (CMS) conduct a focused review to determine the extent of program integrity oversight of the managed care program at the state level.

 

Payment Error Rate Measurement (PERM) is a cyclical audit performed every three years by CMS. The purpose of PERM is to comply with the Improper Payments Information Act (IPIA) by reviewing programs that are susceptible to improper payments.

 

Medicaid Disproportionate Share Hospital Share (DSH) is an annual audit conducted by CMS to ensure the appropriate use of Medicaid DSH payments and compliance with the statutorily imposed hospital-specific limits.

 

Narrative last updated:  11/19/2020

Scorecard Result Container Indicator Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy