Examination – Fiscal Year Ended June 30, 2024

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Report Summary

Background

AOA presents an examination of the Disproportionate Share Hospital (DSH) Payments Program for the Delaware Psychiatric Center and the Saint Francis Hospital facility for the fiscal year ended June 30, 2024 including internal controls over financial reporting and tests of its compliance with certain provisions of laws, regulations, contracts, and grants. 

For states to receive Federal Financial Participation for DSH payments, federal law requires states to submit an independent certified audit and an annual report to the Secretary describing DSH payments made to each DSH hospital. The State Auditor is authorized under 29 Del. C., §2906 to conduct of all financial transactions of all state agencies. 

The State of Delaware, Department of Health and Social Services (DHSS), Division of Medicaid and Medical Assistance (DMMA) administers the Disproportionate Share Hospital (DSH) payments to qualifying hospitals that serve a large number of Medicaid eligible and uninsured individuals. This program is regulated by the federal government. The States that receive federal funding must certify on an annual basis that they are in compliance with the six verifications under the federal regulations 42 CFR, Parts 447 and 455 and meet the requirements of the State of Delaware’s Medicaid State Plan Section 4.19A.  Management of the Program are responsible for complying with these requirements including design, implementation, and maintenance of internal controls.

This examination engagement was conducted in accordance with attestation standards established by the American Institution of Certified Public Accountants and Government Audit Standards issued by the Comptroller General of the United States of America.  

Key Information and Findings

The Disproportionate Share Hospital (DSH) Payments Program for the Delaware Psychiatric Center and the Saint Francis Hospital facility have complied, in all material respects, with the above-mentioned criteria therefore receiving a clean opinion.

There were no deficiencies found in internal control over financial reporting in the period ended June 30, 2024