Summary

This operational audit of the Agency for Health Care Administration (Agency) focused on administrative activities specifically related to tangible personal property, the Medicaid nursing home overpayment account, the Agency’s database of Other Cost Accumulators (OCAs), background screening of Agency employees, the assessment and collection of certain hospital fees, cellular telephones, and travel.  We also followed up on Finding No. 4 of audit report No. 2006-046, related to the Agency’s rule making responsibilities for the Florida KidCare Program.  Our audit included the period July 2005 through February 2007, and selected actions through June 2007.

With the exception of the following findings, our audit disclosed that for the controls and related transactions tested, the controls were operating effectively, the transactions were accurately recorded in applicable records, and the Agency demonstrated compliance with applicable significant laws, rules, and other guidelines: 

Tangible Personal Property

Finding No. 1:     The Agency needs to enhance tangible personal property (TPP) policies and procedures to ensure that the annual physical inventory is timely and accurately reconciled with property records and that all potential record errors and losses of equipment are timely investigated.

Finding No. 2:     The Agency needs to improve procedures to ensure TPP is timely and accurately recorded.

Finding No. 3:     Insurance coverage purchased for Agency building contents significantly exceeded the amount required.

Nursing Home Overpayment Account

Finding No. 4:     The Agency has not established rules pertaining to the administration and management of the Medicaid nursing home overpayment account, including specification of situations which will result in withdrawals from the account.  In addition, the Agency did not perform annual reviews to evaluate the financial viability of the account.

Other Cost Accumulators

Finding No. 5:     The Agency has not established written policies and procedures for OCA utilization and maintenance of the OCA database. 

Background Screenings

Finding No. 6:     It was not clear from Agency records that all required employee background screenings had been performed.

Hospital Assessments

Finding No. 7:     The Agency did not facilitate hospital payment of assessments by no later than the first day of each quarter, the payment due date set by law.

Cellular Telephones

Finding No. 8:     The Agency did not follow policies and procedures established to reasonably ensure that State-owned cellular telephones were used for an authorized public purpose and that any incidental personal use was identified and reimbursed.

Follow-up on the KidCare Program

Finding No. 9:   The Agency needs to continue efforts to implement rules for the Florida KidCare Program.

The Secretary's response is included in its entirety at the end of this report as Appendix A.