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5/1/2024 Auditor General issues Single Audit Report for the fiscal year ended June 30, 2023
STATE HOUSE — Continued premium payments to managed care organizations for deceased Medicaid members, material noncompliance with specific federal requirements, needed improvements in information security, and internal control and documentation deficiencies impacting federal compliance were just some of the findings noted in the Auditor General’s annual audit of the state’s compliance with federal program requirements.

The annual Single Audit of the State of Rhode Island for the fiscal year ended June 30, 2023, resulted in 68 findings related to the administration of federal programs and the state’s key financial operations. Expenditures of federal programs totaled $7.0 billion for fiscal 2023, of which $1.4 billion was COVID-related. Substantial amounts of federal assistance continued to be expended in fiscal 2023. Total federal expenditures in 2023 increased by $120 million over the prior fiscal year. Recovery efforts funded by Coronavirus State and Local Fiscal Recovery Funds increased by $268.3 million in fiscal 2023, while assistance for pandemic-related unemployment insurance, and rent relief through the Emergency Rental Assistance Program, reduced significantly as compared to fiscal 2022.

The Single Audit Report, prepared by Auditor General David A. Bergantino, was recently released by the Joint Committee on Legislative Services. The annual audit is required by both state and federal law as a condition of continued federal assistance.

The Single Audit Report also includes a detailed schedule of federal award expenditures and audit reports outlining internal control deficiencies and noncompliance relating to financial reporting and the administration of federal programs. The report includes the state’s financial statements which were previously communicated in the state’s fiscal 2023 Annual Comprehensive Financial Report.

Federal assistance is received under approximately 500 individual programs. Many programs are jointly financed with federal and state funding. Medicaid is the single largest program, with fiscal 2023 expenditures totaling approximately $3.7 billion; the federal government shared $2.4 billion of that cost.

Of the 68 findings included in the report, 39 relate to the administration of federal programs, with the remainder relating to the state’s controls over financial reporting (previously issued in March 2024 with the state’s 2023 audited financial statements). The auditors noted material noncompliance with federal requirements in eight out of the 21 major federal programs audited in fiscal 2023.

Control deficiencies within the Medicaid program continued to result in premium payments to managed care organizations being disbursed for deceased members. In addition, operational and control deficiencies continued to result in (1) members being claimed for enhanced federal reimbursement under Medicaid Expansion provisions after the age of 65 and (2) premium payments for members no longer residing in the state.

Operational and system deficiencies in the Children’s Health Insurance Program (CHIP) continued to result in noncompliance as children with existing third-party health coverage were improperly claimed for enhanced federal reimbursement. In addition, control deficiencies resulted in members over the age of 19, excluding those that met federal public health emergency (PHE) exception criteria, being improperly claimed for enhanced reimbursement.

Noncompliance was noted in several health and human services programs (Medicaid, CHIP, Temporary Assistance to Needy Families and Child Care) due to insufficient documentation of critical program eligibility requirements. Documentation lacking in support of household income, residency and redetermination were the most common deficiencies noted.

Findings were also noted in multiple programs relating to federal requirements for subrecipient monitoring and federal reporting.

Management’s response and planned corrective actions are included within the Single Audit Report. A Summary Schedule of Prior Audit Findings, which reports the status of findings from prior audits, is also included.

Since the goal of the annual Single Audit is to highlight areas where the state can improve federal compliance, reported findings do attempt to identify when progress has been made by the state to improve compliance. In addition, the Summary Schedule of Prior Audit Findings indicates when prior corrective actions have been initiated and implemented to resolve audit findings.

The state’s Single Audit Report was submitted to the Federal Single Audit Clearinghouse on April 30, 2024; this information is then made available to all federal funding agencies. The Single Audit Report and related Audit Summary are available on the Office of the Auditor General’s website:

State of RI 2023 Single Audit Report
State of RI 2023 Single Audit Report - Audit Summary

For more information, contact:
Meredyth R. Whitty, Publicist
State House Room 20
Providence, RI 02903
(401) 222-1923