Audit 408060

2025-001 Sliding Fee Discount Determination CFDA Number: 93.224 Program: Community Health Center Cluster Agency: US Department of Health and Human Services Compliance Requirement: N Special Tests and Provisions Repeat Finding: Yes Criteria: Federal grant compliance provisions require that the Organization correctly identify a patient's ability to pay and that the rates for services be adjusted accordingly based on the sliding fee schedule. The Organization is required to follow its sliding fee policy when providing discounts to eligible patients. Finding/ Condition: In our sample of 40 tested items, incorrect sliding fee discounts were provided in 10 samples. Questioned Cost: None. Effect: Lack of strict enforcement of the policy of sliding fee eligibility determination and compliance may have resulted in the Organization providing discounted services greater to or less than the appropriate amounts to beneficiaries. Cause: Inadequate understanding of the sliding fee program requirements and Organization policies by employees involved in sliding fee determination and billing. Recommendation: Training should be provided to employees on the sliding fee program requirements. The Organization should perform regular audits of sliding fee transactions to identify weaknesses in compliance. Views of Responsible Officials and Corrective Action Plan: The Organization agrees with the finding and will implement additional controls to ensure that this does not recur. Please refer to the corrective action plan on page 35.

2025-002 Procurement Suspension and Debarment ALN: 93.224 Program: Community Health Center Cluster Agency: US Department of Health and Human Services Compliance Requirement: I Procurement Suspension and Debarment Repeat Finding: No Criteria: Per 45 CFR 75.327(i), a non-Federal entity who receives HHS awards must maintain records sufficient to detail the history of procurement. These records will include, but are not necessarily limited to the following: rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price. Finding/Condition: During our testing of the Organization’s procurement transactions for federal purchases (25 samples), we noted the Organization could not provide a sufficient history of the procurement decisions including the method of procurement and contractor selection. Questioned Cost: None. Effect: The entity is not in compliance with 45 CFR 75.327 for procurement. Cause: The Organization did not have procedures in place for procurement in retaining the required documentation detailing the history of the procurement. Recommendation: We recommend the Organization develop procedures for procurement with federal funds. Views of Responsible Officials and Corrective Action Plan: The Organization will develop a system that maintains the required documentation for procurements in a centralized location. Please refer to the Corrective Action Plan on page 35.