Audit 394322

Federal Program Identification: U.S. Department of Health and Human Services Health Centers Cluster - Consolidated Health Center Program, AL 93.224, and Grant Number: H8000678 Condition/Criteria: Community Health Centers are required to offer sliding fee discounts to patients with annual incomes at or below 200% of the federal poverty guidelines. While the Organization has established policies to administer these discounts, opportunities exist to strengthen controls, particularly in documentation practices. Supporting documentation used to determine sliding fee discounts is not consistently maintained in every patient file. Cause: A system conversion has resulted in procedures related to the maintenance of required documentation for sliding fee determinations not being fully implemented or consistently followed in accordance with the Organization’s established policies. Effect: Without proper documentation, there is a risk that patients may receive incorrect sliding fee discounts, potentially resulting in overpayment or underpayment for services. Recommendation: We recommend the Organization enhance its procedures to ensure that all required documentation used in the determination of sliding fee discounts is consistently collected and retained in each patient's file. View of Responsible Officials and Planned Corrective Action: See corrective action plan.