March 11, 1999
Report No. 99-14
Some problems were discovered as a result of the Single Federal Audit conducted by our office. The Single Audit meets federal requirements and covers expenditures of federal awards totaling $4.7 billion by the state during the year ended June 30, 1998. The Single Audit is the most comprehensive government audit conducted by the state auditor's office; almost two-thirds of the federal funding involved goes to the Missouri Department of Social Services. Our findings and recommendations, as well as agency responses, begin on page 26. The following findings are especially noteworthy.
Department of Social Services / Division of Family Services:
Thousands of individuals were receiving welfare benefits who have not had their Social Security number verified and entered into the state computer system which is fundamentally important to ensure the ability to check for fraud, overpayment, or duplicate payments. We found that more than nine-thousand welfare recipients did not have a social security number in the state's computer system. (See Eligibility-Social Security Number # 98-18 / pages 47-48)
The lack of action by caseworkers has in some cases led to the continuation of welfare benefits even when the person has died. (See Eligibility-Death Match #98-16 / pages 44-46)
Missouri Department of Transportation:
The state transportation department needs to ensure that local agencies solicit bids from at least three engineering firms for bridge projects. Other audits have noted that some counties do not solicit bids which is restrictive and exclusive, and contrary to state law. (See Subrecipient Monitoring # 98-8 / pages 33-35)
Department of Social Services / Division of Medical Services:
We discovered that some nursing homes are being paid by the state for patients who are in hospice care. In addition, the hospice care is also being paid for by the state. During the year ended June 30, 1998, overpayments of $159,380 were noted. It appears this double dipping may have existed since May 1989, when hospice providers began receiving nursing home per diems. (See Nursing Home and Hospice Claim Overpayments # 98-25 / page 55)
We also discovered that medicaid benefits totaling $108,221 were paid for persons after they had died. (See Ineligible Payments #98-24 / page 54)
The Division of Medical Services has not collected $423,670 owed to the state from drug companies. (See Drug Rebate Program #98-26 / pages 55-56)
The division also overpaid $301,096 to one hospital and has not collected $815,972 owed to the state from another hospital. (See Hospital Overpayments #98-28 / pages 58-60)
Department of Elementary and Secondary Education:
The state may have to return $261,149 to the federal government because the grant funds were not used by the federal government's deadline. (See Period of Availability of Funds #98-5 / pages 30-31)