Audit 389818

MATERIAL WEAKNESS Federal Agency: U.S. Department of Health and Human Services Assistance Listing Number: 93.224 2024-002: Improper Application of the Sliding Fee Scale Compliance Requirement: Special Tests and Provisions Criteria – The Health Center should apply the sliding fee scale based on patient income and family size for qualifying individuals. Condition – Based on the 40 patients selected for Single Audit compliance testing, we noted 10 errors. In each instance, we noted that the wrong class was selected when applying the sliding fee discount to patient balances based on the patient’s individual incomes and family size of their respective households, resulting in the wrong discount being applied. Cause – The cause of this deficiency was an error in the application of the effective sliding fee discount schedule based on the verified income and household size of each respective patient. Effect – The effect was an improper sliding fee discount being applied to various patient accounts based on the effective sliding fee discount schedule and policy. Recommendation – We recommend that the Health Center review procedures to ensure that sliding fee discounts are properly applied and posted to patient accounts for eligible encounters. Management’s Response – We recognize the needs for proper internal control processes and procedures to ensure that sliding fee discounts are properly applied and posted to patient accounts for eligible encounters.