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Appendix C – Overview of the File Review

Objective:

The objective of drawing the sample for the audit will be to verify that remissions have followed appropriate business processes and are compliant with legislation and the root cause of the overpayment.

Definition of the population and sampling unit:

The audit will include all remissions processed for the 2010-2011 fiscal year. A single remission transaction will be the sampling unit.

Sampling Technique:

The sampling methodology will be a random sample drawn from the entire remission transactions population for 2010/2011. The percentage to be drawn randomly from the entire population will be 50%.

Attributes to be tested:

  1. An overpayment has occurred.
  2. Reason for overpayment (it meets at least one of the four criteria for remission).
  3. Compliance with remission legislative requirements.
  4. Review of overpayment and remission processing times.

Testing Standards

A random sample of 50% will be drawn from the entire 2010/2011 remission transaction population in order to determine the number of transactions to include in the file review.

Sample Size

Based on the current data for the 2010/2011 remission transaction population, 67 files (134*.5) will be drawn for review. The following table provides population and sampling statistics.

Random Sample
Program Random Sample Population
WVA Remissions 46 98
VIP Remissions 10 13
NVC and Pension Remissions 11 23
Total 67 134
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