Audit 365587

ALN: 93.224 Program: Community Health Center Cluster Agency: US Department of Health and Human Services Compliance Requirement: N- Special Tests and Provisions Repeat Finding: No Criteria: Federal grant compliance provisions require that the Center correctly identify a patient's ability to pay and that the rates for services be adjusted accordingly based on the sliding fee schedule. Center is required to follow its sliding fee policy when providing discounts to eligible patients. Condition: In our sample of 40 tested items, for multiple selections patient information was inadequate to determine the proper sliding fee discount or the patient signed application was not available. Questioned Cost: None. Effect: Lack of strict enforcement of the policy of sliding fee eligibility determination and compliance may have resulted in Center providing discounted services greater to or less than the appropriate amounts to beneficiaries. Cause: Inadequate retention of the sliding fee program documentation requirements and Center policies by employees involved in sliding fee process. Recommendation: Training should be provided to employees on the sliding fee program requirements. Center should perform regular audits of sliding fee transactions to identify weaknesses in compliance. Views of Responsible Officials and Corrective Action Plan: Center agrees with the finding and will implement additional controls to ensure that this does not recur. Please refer to the corrective action plan.

ALN: 93.224 Program: Community Health Center Cluster Agency: US Department of Health and Human Services Compliance Requirement: N- Special Tests and Provisions Repeat Finding: No Criteria: Federal grant compliance provisions require that the Center correctly identify a patient's ability to pay and that the rates for services be adjusted accordingly based on the sliding fee schedule. Center is required to follow its sliding fee policy when providing discounts to eligible patients. Condition: In our sample of 40 tested items, for multiple selections patient information was inadequate to determine the proper sliding fee discount or the patient signed application was not available. Questioned Cost: None. Effect: Lack of strict enforcement of the policy of sliding fee eligibility determination and compliance may have resulted in Center providing discounted services greater to or less than the appropriate amounts to beneficiaries. Cause: Inadequate retention of the sliding fee program documentation requirements and Center policies by employees involved in sliding fee process. Recommendation: Training should be provided to employees on the sliding fee program requirements. Center should perform regular audits of sliding fee transactions to identify weaknesses in compliance. Views of Responsible Officials and Corrective Action Plan: Center agrees with the finding and will implement additional controls to ensure that this does not recur. Please refer to the corrective action plan.