Audit 345714

Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Centers Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS02457‐20; H80CS02457‐21 Award Periods: February 1, 2023 – January 31, 2024; February 1, 2024 – January 31, 2025 Type of Finding: Compliance and significant deficiency in internal control over compliance Criteria: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The organization assessed two patients with a larger sliding fee discount than for which they were eligible based on their family size and income documentation. Questioned Costs: None. Context: Two (2) of Forty (40) transactions selected for testing. Cause: One patient was assessed a higher discount than eligible for as a result of a system error and one patient was assigned a higher discount due to a posting error when documenting the patient encounter. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No Recommendation: We recommend the organization enhance is internal controls over compliance specific to the assignment and review of sliding fee discounts assigned to patients.

Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Centers Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS02457‐20; H80CS02457‐21 Award Periods: February 1, 2023 – January 31, 2024; February 1, 2024 – January 31, 2025 Type of Finding: Compliance and significant deficiency in internal control over compliance Criteria: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The organization assessed two patients with a larger sliding fee discount than for which they were eligible based on their family size and income documentation. Questioned Costs: None. Context: Two (2) of Forty (40) transactions selected for testing. Cause: One patient was assessed a higher discount than eligible for as a result of a system error and one patient was assigned a higher discount due to a posting error when documenting the patient encounter. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No Recommendation: We recommend the organization enhance is internal controls over compliance specific to the assignment and review of sliding fee discounts assigned to patients.

Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Centers Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS02457‐20; H80CS02457‐21 Award Periods: February 1, 2023 – January 31, 2024; February 1, 2024 – January 31, 2025 Type of Finding: Compliance and significant deficiency in internal control over compliance Criteria: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The organization assessed two patients with a larger sliding fee discount than for which they were eligible based on their family size and income documentation. Questioned Costs: None. Context: Two (2) of Forty (40) transactions selected for testing. Cause: One patient was assessed a higher discount than eligible for as a result of a system error and one patient was assigned a higher discount due to a posting error when documenting the patient encounter. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No Recommendation: We recommend the organization enhance is internal controls over compliance specific to the assignment and review of sliding fee discounts assigned to patients.

Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Centers Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS02457‐20; H80CS02457‐21 Award Periods: February 1, 2023 – January 31, 2024; February 1, 2024 – January 31, 2025 Type of Finding: Compliance and significant deficiency in internal control over compliance Criteria: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The organization assessed two patients with a larger sliding fee discount than for which they were eligible based on their family size and income documentation. Questioned Costs: None. Context: Two (2) of Forty (40) transactions selected for testing. Cause: One patient was assessed a higher discount than eligible for as a result of a system error and one patient was assigned a higher discount due to a posting error when documenting the patient encounter. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No Recommendation: We recommend the organization enhance is internal controls over compliance specific to the assignment and review of sliding fee discounts assigned to patients.