Audit 372390

2024-003 Information on the Federal Program: Assistance Listing Number 93.224/93.527; Health Center Program Cluster; Department of Health and Human Services Criteria Or Specific Requirement: Reporting: Health centers must comply with federal reporting requirements. Condition: The Center’s data did not support certain line items reported on the Uniform Data System (UDS) and Federal Financial reports filed. Within Table 5 of the UDS report, the visits reported within column B included both in-person and virtual visits where it should not include virtual visits as those are filed in column b2. Within Table 8A of the UDS report, the amounts reported within line 17 column C, line 1, column C, and line 3, column C, were supported by underlying data, but this information significantly understated expenses compared to audited numbers. Within Table 9E of the UDS report, the amounts reported within line 1Q, column A, included a supplemental grant that should not have had an impact on 2024, but rather 2023. The Federal Financial Report’s calculation of program income was incorrect after comparing to audited numbers and did not include all sources of program income. Cause: Internal controls were not in place to ensure proper reconciliation of the supporting documentation used in the submitted UDS and FFR. Effect or Potential Effect: Inaccurate filing of reports may result in the federal program not being properly monitored, thus resulting in potential noncompliance with program requirements. Questioned Costs: None. Context: Out of a total population of four reports: 1 UDS and 3 Federal Financial reports we tested two reports, the UDS and 1 Federal Financial report. Both tested reports included errors within them. The sample was not statistically valid. Identification as a Repeat Finding, if Applicable: Not a repeat finding. Recommendation: We recommend management implement an additional level of review by an individual with knowledge of the reporting requirements. Views of Responsible Officials and Planned Corrective Actions: Management acknowledged inaccuracies in the FFR and UDS tables that support the report which was filed. In future periods, management will have processes and procedures in place to require reconciliation and tie-out of supporting documentation to each of the final filings prior to submission. The Chief Financial Officer will also perform a formal review of both the FFR and UDS tables and document accordingly.

2024-004 Information on the Federal Program: Assistance Listing Number 93.224/93.527; Health Center Program Cluster; Department of Health and Human Services Criteria Or Specific Requirement: Special Tests and Provisions – Sliding Fee Discounts: Health centers must prepare and apply a sliding fee discount schedule, so the amounts owed for health center services by eligible patients are discounted based on patient’s ability to pay. Condition: The Center had incorrect slide discounts applied to patient encounters based on family size and income on initial intake of information. Also, there were multiple billing codes that received discounts based on commercial insurance allowed costs rather than the center’s fee schedule, which is not allowed. Cause: The intake personnel filed the incorrect slides based on family size and income that eventually got applied to the electronic health records system. There was also incorrect discount methodologies coded to the electronic health records system that resulted in unallowed applied discounts. Effect or Potential Effect: Inaccurate discounts provided to patients based on their ability to pay which could result in over or under payment. Questioned Costs: None. Context: There were 25 patient encounters tested and there were improper discounts applied to 6 during the year. The sample was not statistically valid. Identification as a Repeat Finding, if Applicable: Not a repeat finding. Recommendation: We recommend management review their sliding fee policies and schedules for complexity and increase training provided to their full revenue cycle team. Views of Responsible Officials and Planned Corrective Actions: Management acknowledged the sliding fee adjustment errors resulted from incorrect calculation of sliding fee discount. Management will add an additional layer of review over the application of the sliding fee scale. Further, the Center will implement a process to periodically review sliding fee adjustments throughout the year for accuracy.