Audit 393120

Assistance Listing, Federal Agency, and Program Name - 93.224, 93.527 - Health Center Program Cluster Federal Award Identification Number and Year - 23H80CS30717, 23H8LCS51933C6, 23H8GCS48653; 2024-2025 Pass through Entity - No Finding Type - Material weakness and material noncompliance with laws and regulations Repeat Finding - No Criteria - Per 2 CFR 200.303 and 42 USC 254b(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g), health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. The Organization is responsible for the design, implementation, and maintenance of effective internal control over compliance with the requirements of laws, statutes, regulations, rules, and provisions of contracts or grant agreements applicable to the Organization's federal programs. Condition - During the current year, the Organization did not apply the sliding fee scale discount to certain patient claims accurately. During our testing, we noted 13 instances of the sliding fee scale not being accurately applied to patient services out of the 40 transactions tested. Questioned Costs - None If questioned costs are not determinable, description of why known questioned costs were undetermined or otherwise could not be reported - N/A no questioned costs Identification of How Questioned Costs Were Computed - None Context - During the testing of the sliding fee scale discount, it was noted that 13 of the 40 patient claims tested did not have the sliding fee scale discount properly or consistently applied when the patient was eligible. The Organization was not properly and consistently applying the sliding fee scale discount to patients that were eligible. Cause and Effect - The Organization did not apply the sliding fee scale discount appropriately to the eligible patients. This caused patients to be overcharged for services. Recommendation - The Organization should apply the sliding fee scale discount consistently and accurately to all eligible patients. Views of Responsible Officials and Corrective Action Plan - Management acknowledges the sliding fee scale discount should have been applied consistently and accurately and plan to improve the process going forward. Management corrected the patient accounts by applying the sliding fee scale discount.