Audit of the Catastrophic Illness in Children Relief Fund

This is a state audit of the Catastrophic Illness in Children Relief Fund, a Massachusetts program that reimburses families for major child medical costs not covered elsewhere.

“This assistance is provided through reimbursements to families to cover qualified medical expenses they have incurred.”

Auditors checked whether the fund helped eligible families, paid only allowed expenses, and tried to recover federal matching money when possible.

“The purpose of this audit was to determine whether CICRF met the needs of families that applied for financial assistance, whether it sought federal matching funds (also called federal financial participation) in accordance with state regulations for all eligible medical expenses, and whether it disbursed funds only to eligible applicants and only for qualified expenses.”

Families using this program may already be under serious financial strain, so delays and mistakes can make a hard situation worse.

“As a result of these processing delays, families seeking reimbursement for medical expenses might incur financial hardship.”

If you are a Massachusetts family facing large medical costs for a child, this program may reimburse certain costs that insurance or public benefits do not cover.

“Medical expenses are not reimbursable if they are covered by health insurance, public benefits, or other financial sources.”

The fund was serving families, but the audit found weak paperwork controls, slow processing, and missed federal reimbursement opportunities.

“CICRF reimbursed applicants $24,455 for medical expenses without required documentation.”

Auditors recommended stronger documentation checks, clearer staff performance goals, and coordination with MassHealth to seek federal matching funds.

“CICRF should develop formal performance standards for employees, including attainable, time-based goals for processing and reviewing applications.”

The program handled millions of dollars for hundreds of families, so better controls and faster processing affect real public money and real household budgets.

“During the audit period, CICRF reimbursed 363 families a total of $3,548,763 for medical expenses and related expenses.”

“Federal financial participation” means federal matching money the state can recover for certain eligible medical costs, often through Medicaid-related programs.

“A state can recover funds from the federal government for certain medical expenses under Medicaid and other human service programs as part of FFP.”