Audit 27204

Program information: AL # 93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health centers must obtain sliding fee applications so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: We tested 60 sliding fee encounters and noted that 1 of 60 sliding fee encounters tested received the wrong slide. We noted 6 of 60 sliding fee applications were missing an approving sign off. We noted 2 of 60 sliding fee applications were missing and not on file. We noted 1 out of 60 sliding fee applications did not properly document an extension in the slide eligibility period. We noted 1 out of 60 sliding fee encounters was not properly charged a lab visit fee in accordance with the policy. Lastly, we noted 1 out of 60 sliding fee encounters had a wrong correcting adjustment applied to the patient account. Questioned Costs: None. Cause and Effect: The Organization failed to follow controls related to sliding fee encounters, including approvals, applications, and appropriate discounts based on supporting documentation and fee scales. Recommendation: We recommend that sliding fee applications be completed and properly approved for each sliding fee patient. The Organization should develop controls to verify sliding fee discounts applied are correct based on the patient application. The Organization should consider doing sampling throughout the year to verify sliding fee applications are obtained, completed, and agree to the discount applied. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached correct plan.

Program information: AL # 93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health centers must obtain sliding fee applications so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: We tested 60 sliding fee encounters and noted that 1 of 60 sliding fee encounters tested received the wrong slide. We noted 6 of 60 sliding fee applications were missing an approving sign off. We noted 2 of 60 sliding fee applications were missing and not on file. We noted 1 out of 60 sliding fee applications did not properly document an extension in the slide eligibility period. We noted 1 out of 60 sliding fee encounters was not properly charged a lab visit fee in accordance with the policy. Lastly, we noted 1 out of 60 sliding fee encounters had a wrong correcting adjustment applied to the patient account. Questioned Costs: None. Cause and Effect: The Organization failed to follow controls related to sliding fee encounters, including approvals, applications, and appropriate discounts based on supporting documentation and fee scales. Recommendation: We recommend that sliding fee applications be completed and properly approved for each sliding fee patient. The Organization should develop controls to verify sliding fee discounts applied are correct based on the patient application. The Organization should consider doing sampling throughout the year to verify sliding fee applications are obtained, completed, and agree to the discount applied. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached correct plan.

Program information: AL # 93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health centers must obtain sliding fee applications so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: We tested 60 sliding fee encounters and noted that 1 of 60 sliding fee encounters tested received the wrong slide. We noted 6 of 60 sliding fee applications were missing an approving sign off. We noted 2 of 60 sliding fee applications were missing and not on file. We noted 1 out of 60 sliding fee applications did not properly document an extension in the slide eligibility period. We noted 1 out of 60 sliding fee encounters was not properly charged a lab visit fee in accordance with the policy. Lastly, we noted 1 out of 60 sliding fee encounters had a wrong correcting adjustment applied to the patient account. Questioned Costs: None. Cause and Effect: The Organization failed to follow controls related to sliding fee encounters, including approvals, applications, and appropriate discounts based on supporting documentation and fee scales. Recommendation: We recommend that sliding fee applications be completed and properly approved for each sliding fee patient. The Organization should develop controls to verify sliding fee discounts applied are correct based on the patient application. The Organization should consider doing sampling throughout the year to verify sliding fee applications are obtained, completed, and agree to the discount applied. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached correct plan.

Program information: AL # 93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health centers must obtain sliding fee applications so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: We tested 60 sliding fee encounters and noted that 1 of 60 sliding fee encounters tested received the wrong slide. We noted 6 of 60 sliding fee applications were missing an approving sign off. We noted 2 of 60 sliding fee applications were missing and not on file. We noted 1 out of 60 sliding fee applications did not properly document an extension in the slide eligibility period. We noted 1 out of 60 sliding fee encounters was not properly charged a lab visit fee in accordance with the policy. Lastly, we noted 1 out of 60 sliding fee encounters had a wrong correcting adjustment applied to the patient account. Questioned Costs: None. Cause and Effect: The Organization failed to follow controls related to sliding fee encounters, including approvals, applications, and appropriate discounts based on supporting documentation and fee scales. Recommendation: We recommend that sliding fee applications be completed and properly approved for each sliding fee patient. The Organization should develop controls to verify sliding fee discounts applied are correct based on the patient application. The Organization should consider doing sampling throughout the year to verify sliding fee applications are obtained, completed, and agree to the discount applied. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached correct plan.

Program information: AL # 93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health centers must obtain sliding fee applications so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: We tested 60 sliding fee encounters and noted that 1 of 60 sliding fee encounters tested received the wrong slide. We noted 6 of 60 sliding fee applications were missing an approving sign off. We noted 2 of 60 sliding fee applications were missing and not on file. We noted 1 out of 60 sliding fee applications did not properly document an extension in the slide eligibility period. We noted 1 out of 60 sliding fee encounters was not properly charged a lab visit fee in accordance with the policy. Lastly, we noted 1 out of 60 sliding fee encounters had a wrong correcting adjustment applied to the patient account. Questioned Costs: None. Cause and Effect: The Organization failed to follow controls related to sliding fee encounters, including approvals, applications, and appropriate discounts based on supporting documentation and fee scales. Recommendation: We recommend that sliding fee applications be completed and properly approved for each sliding fee patient. The Organization should develop controls to verify sliding fee discounts applied are correct based on the patient application. The Organization should consider doing sampling throughout the year to verify sliding fee applications are obtained, completed, and agree to the discount applied. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached correct plan.

Program information: AL # 93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health centers must obtain sliding fee applications so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: We tested 60 sliding fee encounters and noted that 1 of 60 sliding fee encounters tested received the wrong slide. We noted 6 of 60 sliding fee applications were missing an approving sign off. We noted 2 of 60 sliding fee applications were missing and not on file. We noted 1 out of 60 sliding fee applications did not properly document an extension in the slide eligibility period. We noted 1 out of 60 sliding fee encounters was not properly charged a lab visit fee in accordance with the policy. Lastly, we noted 1 out of 60 sliding fee encounters had a wrong correcting adjustment applied to the patient account. Questioned Costs: None. Cause and Effect: The Organization failed to follow controls related to sliding fee encounters, including approvals, applications, and appropriate discounts based on supporting documentation and fee scales. Recommendation: We recommend that sliding fee applications be completed and properly approved for each sliding fee patient. The Organization should develop controls to verify sliding fee discounts applied are correct based on the patient application. The Organization should consider doing sampling throughout the year to verify sliding fee applications are obtained, completed, and agree to the discount applied. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached correct plan.