Audit 50067

Item 2022-002t Compliance with Client Placement on the Sliding Fee Scale for the Health Center Cluster Program Major Program: Health Center Cluster - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) - ALN/CFD A93.221and Grants for New and Expanded Sevices under the Health Center Program - ALN/CFDA 93.527 Criteria: The Health Center Cluster requires the Organization to perform a financial assessment on consumers in order to place them on a sliding fee scale. The sliding fee scale must be based on the current Federal Poverty Guidelines at the time of assessment. Condition: Consumers are not always placed correctly on the sliding fee scale based on their household size and income level. Questioned Costs: None Context: We tested 40 consumer files for proper placement on the sliding fee scale. During this test we found 2 consumer files that did not reflect two periods of payroll information to verify income in accordance with Center policy. We also found two separate consumer files that did not reflect documentation of income and were placed on sliding fee scale A. We also noted one consumer file that was incorrectly based on sliding fee scale B. The sliding fee discount schedule is used to determine eligibility for patient discounts adjusted on the basis of the patient's ability to pay. This schedule is based on the most recent Federal Poverty Guidelines. Effect: Consumers are not appropriately placed on the sliding fee scale Cause: The Organization's controls over placement of consumers on the sliding fee scale necessary for financial assessment of consumers are not operating effectively. Recommendation: The Organization should review procedures and training regarding the sliding fee scale calculation and placement. Views of Responsible Officials: See management's corrective action plan.

Item 2022-003: Compliance with Sliding Fee Scale Requirements of the Health Center Cluster Program Major Program: Health Center Cluster - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) - ALN/CFDA 93.22,1 and Grants for New and Expanded Services under the Health Center Program - ALN/CFDA 93.527 Criteria: The Health Center Cluster requires the Organization to perform a financial assessment on consumers in order to place them on a sliding fee scale. The sliding fee scale must be based on the current Federal Poverty Guidelines at the time of assessment. Condition: As of the time of the audit in mid-July, the Center's sliding fee scale had not yet been updated to incorporate the most recent Federal Poverty Guidelines which were released on February l, 2022. Questioned Costs: None Effect: Consumers may not be appropriately placed on the sliding lee scale Cause: The Organization's placement on the sliding fee scale necessary for financial assessment of consumers had not been updated to incorporate the most recent Federal Poverty Guidelines. Recommendation: The Organization should develop procedures that ensure the sliding fee scale discount schedule is updated timely upon release of the annual Federal Poverty Guidelines. Views of Responsible Officials: See management's corrective action plan.

Item 2022-002t Compliance with Client Placement on the Sliding Fee Scale for the Health Center Cluster Program Major Program: Health Center Cluster - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) - ALN/CFD A93.221and Grants for New and Expanded Sevices under the Health Center Program - ALN/CFDA 93.527 Criteria: The Health Center Cluster requires the Organization to perform a financial assessment on consumers in order to place them on a sliding fee scale. The sliding fee scale must be based on the current Federal Poverty Guidelines at the time of assessment. Condition: Consumers are not always placed correctly on the sliding fee scale based on their household size and income level. Questioned Costs: None Context: We tested 40 consumer files for proper placement on the sliding fee scale. During this test we found 2 consumer files that did not reflect two periods of payroll information to verify income in accordance with Center policy. We also found two separate consumer files that did not reflect documentation of income and were placed on sliding fee scale A. We also noted one consumer file that was incorrectly based on sliding fee scale B. The sliding fee discount schedule is used to determine eligibility for patient discounts adjusted on the basis of the patient's ability to pay. This schedule is based on the most recent Federal Poverty Guidelines. Effect: Consumers are not appropriately placed on the sliding fee scale Cause: The Organization's controls over placement of consumers on the sliding fee scale necessary for financial assessment of consumers are not operating effectively. Recommendation: The Organization should review procedures and training regarding the sliding fee scale calculation and placement. Views of Responsible Officials: See management's corrective action plan.

Item 2022-003: Compliance with Sliding Fee Scale Requirements of the Health Center Cluster Program Major Program: Health Center Cluster - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) - ALN/CFDA 93.22,1 and Grants for New and Expanded Services under the Health Center Program - ALN/CFDA 93.527 Criteria: The Health Center Cluster requires the Organization to perform a financial assessment on consumers in order to place them on a sliding fee scale. The sliding fee scale must be based on the current Federal Poverty Guidelines at the time of assessment. Condition: As of the time of the audit in mid-July, the Center's sliding fee scale had not yet been updated to incorporate the most recent Federal Poverty Guidelines which were released on February l, 2022. Questioned Costs: None Effect: Consumers may not be appropriately placed on the sliding lee scale Cause: The Organization's placement on the sliding fee scale necessary for financial assessment of consumers had not been updated to incorporate the most recent Federal Poverty Guidelines. Recommendation: The Organization should develop procedures that ensure the sliding fee scale discount schedule is updated timely upon release of the annual Federal Poverty Guidelines. Views of Responsible Officials: See management's corrective action plan.