Audit 368497

Special Tests and Provisions Federal Agency: U.S. Department of Health and Human Services (HHS) Federal Program Name: Consolidated Health Centers (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, Public Housing Primary Care, and School Based Health Centers); (HHS Community Health Center Program) Assistance Listing Number: 93.224/93.527 Criteria or specific requirement: Health centers must prepare and apply a sliding fee discount so that the amounts owed for health center services by eligible patients are adjusted based on the patient’s ability to pay. Condition: During sample of 40 sliding fee patient encounters, we noted that 2 patient visits where the sliding fee adjustment was incorrectly applied based on the income amount provided by the patient to the Organization. Questioned Costs: None Context: The Organization did not properly apply a sliding fee adjustment to 2 of 40 patients tested. Cause: The error was due to manual data entry errors made by the front desk staff. Effect: Two patients received a sliding fee adjustment of approximately $165 more than their applicable sliding fee bracket, based on the patients documented income. Repeat finding: No. Recommendation: We recommend that management continue to educate front desk and intake staff on the importance of the required patient application documentation and review of support before applying a sliding fee adjustment to the patient account. In addition, we suggest management establish a policy to perform regular monitoring of sample patient file fee applications and to document the results. Views of responsible officials: Management of the Organization agrees with the above finding and recommendations and has established a system on internal monitoring, on a random, basis of sliding fee discounts applied by front desk staff.