Audit 397880

Program Name/ALN Title: Health Center Cluster Federal Assistance Listing Number: 93.224/93.527 Federal Agency: U.S. Department of Health and Human Services Award Period: 6/1/2024 – 5/31/2025, 6/1/25-5/31/26 Criteria: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. (42 USC 254(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)). Condition: The organization assessed one patient with an incorrect sliding fee discount based on their family size and income documentation. Context: One (1) of forty (40) transactions selected for testing. In the one instance, the organization collected less patient payments then they were entitled to. Cause: Oversight. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their associated family size and income. Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Views of the Responsible Officials: There is no disagreement with the audit finding.

Program Name/ALN Title: Health Center Cluster Federal Assistance Listing Number: 93.224/93.527 Federal Agency: U.S. Department of Health and Human Services Award Period: 6/1/2024 – 5/31/2025, 6/1/25-5/31/26 Criteria: 2 CFR 200.334 indicates that financial records, supporting documents, statistical records, and all other non-Federal entity records pertinent to a Federal award must be retained for a period of three years from the date of submission of the final expenditure report or, for Federal awards that are renewed quarterly or annually, from the date of the submission of the quarterly or annual financial report, respectively, as reported to the Federal awarding agency. Condition: A variance was identified between the supporting documentation provided for the key line item in Table 8A, Line 17, Column C and what was reported in the final UDS report. Additionally, documentation was not available to support the amounts reported on Lines 8, Columns b and b2 and Line 10a, Columns b and b2 within Table 5. Context: Three (3) of seven (7) key line items tested. These key line items are reported in Tables 5 and 8A. Cause: Subsequent to the organization submitting its UDS report, it was requested to make a change by the initial UDS reviewer. The organization made the requested change but did not maintain documentation to support the adjusted amounts. For Table 5 the organization initially created a pivot table based on the underlying data but did not retaining this documentation and therefore couldn’t support the amounts reported. Effect: Potential for inaccurate UDS report to be filed. Recommendation: We recommend the organization enhances its current process related to the preparation of the UDS report and reinforce the requirement to maintain documentation to support the amounts reported within the various tables of the UDS report. Views of the Responsible Officials: There is no disagreement with the audit finding.