Audit 35251

FY End
2022-09-30
Total Expended
$3.87M
Findings
8
Programs
6
Organization: Lamoille Health Partners, Inc. (VT)
Year: 2022 Accepted: 2023-01-29

Organization Exclusion Status:

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Contacts

Name Title Type
QLA5UPZEA2G8 David Simmons Auditee
8028880909 Anne Cloutier Auditor
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Notes to SEFA

Title: Federal Expenditures Accounting Policies: 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 allowable or are limited as to reimbursement. No grant monies expended and reported within the Schedule were passed through to subrecipients. De Minimis Rate Used: Y Rate Explanation: The auditee used the de minimis cost rate. During the year ended September 30, 2022, federal expenditures totaled $3,874,617. Grant funds used to acquire property and equipment which has not yet placed in service are included in net assets with donor restrictions on the statement of financial position.

Finding Details

Finding 2022-001: Sliding Fee Discount Federal Agency: U.S. Department of Health and Human Services Award Name: Community Health Centers Program Year: October 1, 2021 ? September 30, 2022 Assistance Listing Number: 93.527/93.224 Criteria: The health center 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. Condition: During compliance testing, it was identified that the sliding fee discount was not accurately applied to two patients out of a sample of 25. An additional patient did not have any support on file for the discount they received. Context: Some patients did not receive the proper discount based on the approved sliding fee schedule. Cause: The billing system utilized by the Organization does not automatically apply the discount, therefore requiring the Organization's billing team to review and manually adjust patient bills. Effect: As a result of the condition, some patients received incorrect bills. Recommendation: In the future, the Organization should work with the billing system vendor to automate the billing within the system. Additionally, the Organization should implement appropriate processes and controls to ensure a review is performed prior to sending patient bills. Views of Responsible Officials: Management acknowledges the finding and will work with the system vendor to correct the discount process.
Finding 2022-001: Sliding Fee Discount Federal Agency: U.S. Department of Health and Human Services Award Name: Community Health Centers Program Year: October 1, 2021 ? September 30, 2022 Assistance Listing Number: 93.527/93.224 Criteria: The health center 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. Condition: During compliance testing, it was identified that the sliding fee discount was not accurately applied to two patients out of a sample of 25. An additional patient did not have any support on file for the discount they received. Context: Some patients did not receive the proper discount based on the approved sliding fee schedule. Cause: The billing system utilized by the Organization does not automatically apply the discount, therefore requiring the Organization's billing team to review and manually adjust patient bills. Effect: As a result of the condition, some patients received incorrect bills. Recommendation: In the future, the Organization should work with the billing system vendor to automate the billing within the system. Additionally, the Organization should implement appropriate processes and controls to ensure a review is performed prior to sending patient bills. Views of Responsible Officials: Management acknowledges the finding and will work with the system vendor to correct the discount process.
Finding 2022-001: Sliding Fee Discount Federal Agency: U.S. Department of Health and Human Services Award Name: Community Health Centers Program Year: October 1, 2021 ? September 30, 2022 Assistance Listing Number: 93.527/93.224 Criteria: The health center 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. Condition: During compliance testing, it was identified that the sliding fee discount was not accurately applied to two patients out of a sample of 25. An additional patient did not have any support on file for the discount they received. Context: Some patients did not receive the proper discount based on the approved sliding fee schedule. Cause: The billing system utilized by the Organization does not automatically apply the discount, therefore requiring the Organization's billing team to review and manually adjust patient bills. Effect: As a result of the condition, some patients received incorrect bills. Recommendation: In the future, the Organization should work with the billing system vendor to automate the billing within the system. Additionally, the Organization should implement appropriate processes and controls to ensure a review is performed prior to sending patient bills. Views of Responsible Officials: Management acknowledges the finding and will work with the system vendor to correct the discount process.
Finding 2022-001: Sliding Fee Discount Federal Agency: U.S. Department of Health and Human Services Award Name: Community Health Centers Program Year: October 1, 2021 ? September 30, 2022 Assistance Listing Number: 93.527/93.224 Criteria: The health center 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. Condition: During compliance testing, it was identified that the sliding fee discount was not accurately applied to two patients out of a sample of 25. An additional patient did not have any support on file for the discount they received. Context: Some patients did not receive the proper discount based on the approved sliding fee schedule. Cause: The billing system utilized by the Organization does not automatically apply the discount, therefore requiring the Organization's billing team to review and manually adjust patient bills. Effect: As a result of the condition, some patients received incorrect bills. Recommendation: In the future, the Organization should work with the billing system vendor to automate the billing within the system. Additionally, the Organization should implement appropriate processes and controls to ensure a review is performed prior to sending patient bills. Views of Responsible Officials: Management acknowledges the finding and will work with the system vendor to correct the discount process.
Finding 2022-001: Sliding Fee Discount Federal Agency: U.S. Department of Health and Human Services Award Name: Community Health Centers Program Year: October 1, 2021 ? September 30, 2022 Assistance Listing Number: 93.527/93.224 Criteria: The health center 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. Condition: During compliance testing, it was identified that the sliding fee discount was not accurately applied to two patients out of a sample of 25. An additional patient did not have any support on file for the discount they received. Context: Some patients did not receive the proper discount based on the approved sliding fee schedule. Cause: The billing system utilized by the Organization does not automatically apply the discount, therefore requiring the Organization's billing team to review and manually adjust patient bills. Effect: As a result of the condition, some patients received incorrect bills. Recommendation: In the future, the Organization should work with the billing system vendor to automate the billing within the system. Additionally, the Organization should implement appropriate processes and controls to ensure a review is performed prior to sending patient bills. Views of Responsible Officials: Management acknowledges the finding and will work with the system vendor to correct the discount process.
Finding 2022-001: Sliding Fee Discount Federal Agency: U.S. Department of Health and Human Services Award Name: Community Health Centers Program Year: October 1, 2021 ? September 30, 2022 Assistance Listing Number: 93.527/93.224 Criteria: The health center 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. Condition: During compliance testing, it was identified that the sliding fee discount was not accurately applied to two patients out of a sample of 25. An additional patient did not have any support on file for the discount they received. Context: Some patients did not receive the proper discount based on the approved sliding fee schedule. Cause: The billing system utilized by the Organization does not automatically apply the discount, therefore requiring the Organization's billing team to review and manually adjust patient bills. Effect: As a result of the condition, some patients received incorrect bills. Recommendation: In the future, the Organization should work with the billing system vendor to automate the billing within the system. Additionally, the Organization should implement appropriate processes and controls to ensure a review is performed prior to sending patient bills. Views of Responsible Officials: Management acknowledges the finding and will work with the system vendor to correct the discount process.
Finding 2022-001: Sliding Fee Discount Federal Agency: U.S. Department of Health and Human Services Award Name: Community Health Centers Program Year: October 1, 2021 ? September 30, 2022 Assistance Listing Number: 93.527/93.224 Criteria: The health center 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. Condition: During compliance testing, it was identified that the sliding fee discount was not accurately applied to two patients out of a sample of 25. An additional patient did not have any support on file for the discount they received. Context: Some patients did not receive the proper discount based on the approved sliding fee schedule. Cause: The billing system utilized by the Organization does not automatically apply the discount, therefore requiring the Organization's billing team to review and manually adjust patient bills. Effect: As a result of the condition, some patients received incorrect bills. Recommendation: In the future, the Organization should work with the billing system vendor to automate the billing within the system. Additionally, the Organization should implement appropriate processes and controls to ensure a review is performed prior to sending patient bills. Views of Responsible Officials: Management acknowledges the finding and will work with the system vendor to correct the discount process.
Finding 2022-001: Sliding Fee Discount Federal Agency: U.S. Department of Health and Human Services Award Name: Community Health Centers Program Year: October 1, 2021 ? September 30, 2022 Assistance Listing Number: 93.527/93.224 Criteria: The health center 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. Condition: During compliance testing, it was identified that the sliding fee discount was not accurately applied to two patients out of a sample of 25. An additional patient did not have any support on file for the discount they received. Context: Some patients did not receive the proper discount based on the approved sliding fee schedule. Cause: The billing system utilized by the Organization does not automatically apply the discount, therefore requiring the Organization's billing team to review and manually adjust patient bills. Effect: As a result of the condition, some patients received incorrect bills. Recommendation: In the future, the Organization should work with the billing system vendor to automate the billing within the system. Additionally, the Organization should implement appropriate processes and controls to ensure a review is performed prior to sending patient bills. Views of Responsible Officials: Management acknowledges the finding and will work with the system vendor to correct the discount process.