Audit 3347

FY End
2023-06-30
Total Expended
$6.24M
Findings
2
Programs
12
Organization: Hidalgo Medical Services (NM)
Year: 2023 Accepted: 2023-11-15

Organization Exclusion Status:

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Contacts

Name Title Type
NFANL539HER6 Gretchen Cannon Auditee
5755422335 Anna Stevens Auditor
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Notes to SEFA

Title: Note 3. Assistance Listing 93.530 Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal awards activity of Hidalgo Medical Services under the programs of the federal government for the year ended June 30, 2023. The information in this schedule is presented in accordance with requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of Hidalgo Medical Services, it is not intended to and does not present the financial position, results of operations, changes in net assets or cash flows of Hidalgo Medical Services. Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowed or are limited to reimbursement. Negative amounts shown on the Schedule, if any, represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: Hidalgo Medical Services has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The Organization received and expended funds from the Affordable Care Act – Teaching Health Center Graduate Medical Education (THCGME) Payments Program. The amount of funds received during the period under audit, $66,667, is not included in the Schedule of Expenditures of Federal Awards above as the program, CFDA 93.530, is exempt from the Uniform Guidance requirements per the program description.
Title: Note 4. Expenditures Incurred in a Prior Year Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal awards activity of Hidalgo Medical Services under the programs of the federal government for the year ended June 30, 2023. The information in this schedule is presented in accordance with requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of Hidalgo Medical Services, it is not intended to and does not present the financial position, results of operations, changes in net assets or cash flows of Hidalgo Medical Services. Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowed or are limited to reimbursement. Negative amounts shown on the Schedule, if any, represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: Hidalgo Medical Services has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The Organization disclosed amounts in the Schedule of Expenditures of Federal Awards incurred in a prior year as follows:
Title: Note 5. Subsequent Events Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal awards activity of Hidalgo Medical Services under the programs of the federal government for the year ended June 30, 2023. The information in this schedule is presented in accordance with requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of Hidalgo Medical Services, it is not intended to and does not present the financial position, results of operations, changes in net assets or cash flows of Hidalgo Medical Services. Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowed or are limited to reimbursement. Negative amounts shown on the Schedule, if any, represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: Hidalgo Medical Services has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The Organization’s management has evaluated subsequent events through November 1, 2023, the date the Schedule of Expenditures of Federal Awards was available to be issued.

Finding Details

Finding 2023-001 – Improper application of sliding fee discount CFDA Nos. – 93.224 and 93.527 Federal Award ID # and Year – 5 H80CS00744-21-00 Program Year 2023 Federal Agency Name: U.S. Department of Health and Human Services Type of finding Significant deficiency in internal control over compliance Criteria or Specific Requirement Special Tests and Provisions: Sliding Fee Discounts per Title 42 Chapter 1 Subchapter D Section 51c303(f) Condition The Organization’s sliding fee program provides discounts on patient services based upon the individual’s level of income. However, the Organization applied the incorrect discount based upon the individual’s income per the Organizations sliding fee discount policy. Cause Clerical error in applying the sliding fee discount adjustment in the billing system for the patient. Effect or Potential Effect Improper sliding fee discounts given to patients. Questioned Costs None Context or Perspective Information A sample of 40 patients were tested out of the total population of 2,283 encounters. The sampling methodology used is not statistically valid. Two patients received the incorrect sliding fee discount based upon their income level. Identification as a repeat finding, if applicable Yes, see prior year finding 2022-001. Recommendation We recommend that the Organization implement a verification process to ensure the sliding fee discounts being applied are in accordance with their sliding fee policy. Views of Responsible Officials and Planned Corrective Actions See corrective action plan
Finding 2023-001 – Improper application of sliding fee discount CFDA Nos. – 93.224 and 93.527 Federal Award ID # and Year – 5 H80CS00744-21-00 Program Year 2023 Federal Agency Name: U.S. Department of Health and Human Services Type of finding Significant deficiency in internal control over compliance Criteria or Specific Requirement Special Tests and Provisions: Sliding Fee Discounts per Title 42 Chapter 1 Subchapter D Section 51c303(f) Condition The Organization’s sliding fee program provides discounts on patient services based upon the individual’s level of income. However, the Organization applied the incorrect discount based upon the individual’s income per the Organizations sliding fee discount policy. Cause Clerical error in applying the sliding fee discount adjustment in the billing system for the patient. Effect or Potential Effect Improper sliding fee discounts given to patients. Questioned Costs None Context or Perspective Information A sample of 40 patients were tested out of the total population of 2,283 encounters. The sampling methodology used is not statistically valid. Two patients received the incorrect sliding fee discount based upon their income level. Identification as a repeat finding, if applicable Yes, see prior year finding 2022-001. Recommendation We recommend that the Organization implement a verification process to ensure the sliding fee discounts being applied are in accordance with their sliding fee policy. Views of Responsible Officials and Planned Corrective Actions See corrective action plan