Each year, states like Louisiana undergo a Single Audit to verify proper use of federal funds. These audits assess internal controls, compliance with requirements, and safeguards against misuse, with special focus on major programs.
The 2024 Single Audit (for fiscal year ended June 30, 2024, issued March 31, 2025) identified serious deficiencies. Auditors issued qualified opinions on three major federal programs:
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Medicaid Cluster and Children's Health Insurance Program (CHIP) — due to ongoing failures in provider enrollment and screening.
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Research and Development Cluster — due to repeated internal control weaknesses over personnel charges, time-and-effort certifications, key personnel changes, and oversight at institutions like LSU Health Sciences Center in Shreveport and UL Lafayette.
These issues persisted for multiple years, increasing the risk of noncompliance and potentially disallowed costs.
Key Issues in Medicaid and CHIP Provider Enrollment
The Louisiana Department of Health (LDH), which administers these programs and received about $13 billion in federal funds in FY 2024, failed for the seventh consecutive year to verify that independent contractors and clinics (including managed care and dental providers) were properly enrolled and screened. Of the 23,170 providers paid, 8,209 (35%) lacked proper enrollment and screening. This creates a substantial risk of payments to ineligible providers, though no specific improper payments were identified in this audit. LDH cannot fully ensure accurate provider data from managed care plans or compliance with federal/state rules.
Research and Development Awards
Public universities, including UL Lafayette and LSU Health Sciences Center in Shreveport, repeatedly demonstrated weaknesses in documenting personnel charges, time-and-effort certifications, approving key personnel changes, and oversight of requisitions. These deficiencies heighten noncompliance risks and could lead to repayments.
Other Notable Finding
The Louisiana Workforce Commission (LWC) failed for the sixth consecutive year to adequately monitor subrecipients under the Workforce Innovation and Opportunity Act (WIOA). It did not ensure timely audit report submissions or prompt management decisions on findings. Of $50 million in WIOA expenditures, $40.7 million went to these subrecipients, raising compliance risks.
Overall Audit Results
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35 findings total, with 16 (46%) as repeats from prior years.
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$260.6 million in federal questioned costs (amounts potentially unsupported, unallowable, or improper; final resolution by federal grantors). Most ($260.1+ million) tied to LDH programs.
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Other agencies with findings included the Department of Children and Family Services, universities, and others, involving issues such as compliance reporting, contract administration, documentation, and internal controls.
The full report is available from the Louisiana Legislative Auditor: https://lla.la.gov/reports/audit-reports/by-agency/state-of-louisiana-single-audit.
These persistent issues highlight ongoing challenges in managing federal dollars responsibly, with many problems recurring despite prior warnings.
Take a look at the federal government’s clearinghouse, where they hold all of the Single Audits. You can track every Louisiana agency and non-profit that receives federal dollars there.