Audit 407582

Significant Deficiency Finding: 2025-001 Sliding Fee Discounts Federal Programs: Department of Health and Human Services Health Center Program Cluster Assistance Listing No. 93.224 and 93.527 Criteria: Uniform Guidance, Special Tests & Provisions, Sliding Fee Discounts, 42 CFR, 56.303 Condition: Health Centers receiving funding under the Health Center Program Cluster must prepare and apply a sliding fee discount so that the amounts owed for health center services by eligible patients are discounted based on the patient’s ability to pay. During testing, it was noted that a manual process within the billing process resulted in failure to appropriately provide a discount to a qualifying patient. In addition, two patients were given discounts when applications were incomplete or unavailable Cause: There were deficiencies in internal controls designed to ensure that proper sliding fee discounts were applied to patient accounts in accordance with the Organization’s sliding fee scale. Effect: Discounts were not properly applied to patient accounts. Questioned Costs: None reported. Context/Sampling: Errors in documentation or discounts were noted for 3 of 48 self-pay patients selected for testing. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: No Recommendation: It is recommended that staff be trained to review sliding fee discounts applied to ensure they are accurate and that proper documentation is maintained. In addition, it is recommended that supervisory level personnel select and review a sample of sliding fee applications and discounts to ensure that staff are properly applying the discounts. Views of Responsible Officials: Management concurs. Efforts will be made to implement corrective actions as recommended above. Contact Person: Anita Case, CEO Anticipated Date of Completion: August 31, 2026