1. Common Mistakes Seen in Audit
(July 1, 2016 – December 31, 2016 Audit Cycle)
&
College Tuition Fee Waiver Program Audit

2. Division of Veteran Services (DVS) Reports - Overview
DVS 19 – Subvention Program Claims
DVS 40 – CalVet College Fee Waiver Claims
DVS 19MC – Medi-Cal Program Claims
DVS 20 – Subvention Program Awards
DVS 20MC – Medi-Cal Program Awards

3. 21-526EZ used as transmittal
DVS 19 – Common Mistakes
non-auditable use
Not benefit enhancement activities
Requesting records
File transfer
Request VA benefit letter
Info in support of claim
21-526EZ used as transmittal
Sent along with
Both claim IU
21-526EZ multiple claims within 8 weeks
2 – 4 weeks after initial FDC
Detailed case note for exceptions

4. DVS 19 - Common Mistakes 10-10 series claims
Limit of one per veteran per fiscal year
Exceptions
10-10CG – for caregiver
10-10d – CHAMPVA for dependent
without basic eligibility
38 CFR § 4.16 (a) – basic ratings
Detailed case note for exception under 38 CFR § 4.16 (b)

5. DVS 19 – Common Mistakes 21-686c without basic eligibility
30% SC to add dependent
Requests to remove dependent
Duplicate claims/activities

6. DVS 19 – Common Mistakes DOCUMENTATION
Claiming WLU credit without documentation
No form in VetPro
Incomplete form in VetPro
Partially complete form in VetPro
Unsigned form in VetPro
No proof of submission to VA

7. DVS 19 – CalVet College Tuition Fee Waiver (DVS 40) Common Mistakes
Limit of one WLU per student per AY
More than one claimed
CalVet delegation of authority letter
Not dated and signed PRIOR to the six month authorization period

8. DVS 19 – CalVet College Tuition Fee Waiver (DVS 40) Common Mistakes
DOCUMENTATION
Incomplete application packets
Plan A
Proof of wartime service/campaign or expedition medal
DVS 40 application service info must be verified
DD 214
Narrative rating decision
Plan B
Accepting unsigned tax documentation
Parents tax return accepted
Both Plan A & B
Dependent info
Proof of SC disability
Incomplete DVS 40 application
Outdated DVS 40 application (e.g. Rev 01/00)

9. DVS 19 Medi-Cal – Common Mistakes
Limit one verification per case per fiscal year
CW5 & MC05
No CW5 or MC05 within 12 months of claim
Invalid Aid Code on CW5
Choosing valid aid code in VetPro

10. DVS 19 Medi-Cal – Common Mistakes
Invalid verification
Manual states what is a valid verification
Valid aid code
Report info
Name of individual who verified info
Return to eligibility worker
DOCUMENTATION
No CW5 or MC05 in VetPro
No record of claim filed with VA
Just activity – no form or proof submitted to VA

11. DVS 20 Award Register – Common Mistakes
Excess amount posted for adding dependents
21-686c with monthly amounts in thousands
Post award for removing spouse
Post award for claims that did not generate award
Denied claims
Confirmed & Continued claims
Duplicate postings
Stale awards
More than 18 months from award notification date

12. DVS 20 Award Register – Common Mistakes
Split Award
All claims stated on award letter
DOCUMENTATION
To support award claim
Prior Awards Verified
Government agency verifications only
Limited to one per case per fiscal year

13. DVS 20 Medi-Cal Award Register – Common Mistakes
Prior awards verified limit one per case per FY
Posting award for non Medi-Cal claims
Must be CW5 or MC05 within 12 months of claim
Stale awards
No documentation to support claim

14. College Tuition Fee Waiver Program Audit
Overview
Begins after each semi-annual Subvention & Medi- Cal Cost Avoidance program audit
Generally November – January; before February 1st semi-annual audit cycle.
Generally May – July; before August 1st semi-annual audit cycle
Looks at most current DVS 40 claims processed
Example – recent audit looked at DVS 40 claims processed from July 1, 2016 – December 2016.

15. College Tuition Fee Waiver Program Audit
Order of who gets audited
Counties that process HIGH amounts of DVS 40 claims
Counties with history of problems processing DVS 40 claims
May be necessary to repeat audit of specific county each cycle
Counties that process LOW amounts of DVS 40 claims
Semi-annual subvention program audit may suffice
Example – county processed three fee waivers
How will I know that I am being audited
Auditor will send you an before the audit begins

16. Subvention Claims Auditor
Thank You for Serving Veterans & Contact Information
Jesus Lopez
Subvention Claims Auditor
(916)