Audit 55407

Finding 2022-002 ? Sliding Fee Determination and Related Patient Billing U.S. Department of Health and Human Services Assistance Listing No. 93.224, Consolidated Health Centers Program Cluster Condition: As part of our compliance testing procedures for the HRSA 330 grant programs, we tested sixty patients billed under a sliding fee discount schedule. Of the patients tested, ten patients (16%) were found to have exceptions as the income verification was either not performed or had not been performed within the past 12 months. Criteria: All section 330-funded health centers must prepare and apply a sliding fee discount schedule (SFDS), which adjust amount owed for health center services by eligible patients based on the patient?s ability to pay. Management is responsible to make sure controls are in place for patients to be charged in accordance with the SFDS and that income verifications are performed at least annually. Cause: Based on audit procedures performed, the income verification process was not performed on an annual basis for patients to be charged the correct amount for their service. Effect: The lack of controls over the income verification process could cause revenue to be over or understated. The impact of the ten patients that did not have appropriate documentation is not able to be quantified. Recommendations: The established policies and controls did not operate effectively in these instances. Management should ensure processes are in place to make sure the income verification process is being performed annually for each patient.

Finding 2022-002 ? Sliding Fee Determination and Related Patient Billing U.S. Department of Health and Human Services Assistance Listing No. 93.224, Consolidated Health Centers Program Cluster Condition: As part of our compliance testing procedures for the HRSA 330 grant programs, we tested sixty patients billed under a sliding fee discount schedule. Of the patients tested, ten patients (16%) were found to have exceptions as the income verification was either not performed or had not been performed within the past 12 months. Criteria: All section 330-funded health centers must prepare and apply a sliding fee discount schedule (SFDS), which adjust amount owed for health center services by eligible patients based on the patient?s ability to pay. Management is responsible to make sure controls are in place for patients to be charged in accordance with the SFDS and that income verifications are performed at least annually. Cause: Based on audit procedures performed, the income verification process was not performed on an annual basis for patients to be charged the correct amount for their service. Effect: The lack of controls over the income verification process could cause revenue to be over or understated. The impact of the ten patients that did not have appropriate documentation is not able to be quantified. Recommendations: The established policies and controls did not operate effectively in these instances. Management should ensure processes are in place to make sure the income verification process is being performed annually for each patient.

Finding 2022-002 ? Sliding Fee Determination and Related Patient Billing U.S. Department of Health and Human Services Assistance Listing No. 93.224, Consolidated Health Centers Program Cluster Condition: As part of our compliance testing procedures for the HRSA 330 grant programs, we tested sixty patients billed under a sliding fee discount schedule. Of the patients tested, ten patients (16%) were found to have exceptions as the income verification was either not performed or had not been performed within the past 12 months. Criteria: All section 330-funded health centers must prepare and apply a sliding fee discount schedule (SFDS), which adjust amount owed for health center services by eligible patients based on the patient?s ability to pay. Management is responsible to make sure controls are in place for patients to be charged in accordance with the SFDS and that income verifications are performed at least annually. Cause: Based on audit procedures performed, the income verification process was not performed on an annual basis for patients to be charged the correct amount for their service. Effect: The lack of controls over the income verification process could cause revenue to be over or understated. The impact of the ten patients that did not have appropriate documentation is not able to be quantified. Recommendations: The established policies and controls did not operate effectively in these instances. Management should ensure processes are in place to make sure the income verification process is being performed annually for each patient.

Finding 2022-002 ? Sliding Fee Determination and Related Patient Billing U.S. Department of Health and Human Services Assistance Listing No. 93.224, Consolidated Health Centers Program Cluster Condition: As part of our compliance testing procedures for the HRSA 330 grant programs, we tested sixty patients billed under a sliding fee discount schedule. Of the patients tested, ten patients (16%) were found to have exceptions as the income verification was either not performed or had not been performed within the past 12 months. Criteria: All section 330-funded health centers must prepare and apply a sliding fee discount schedule (SFDS), which adjust amount owed for health center services by eligible patients based on the patient?s ability to pay. Management is responsible to make sure controls are in place for patients to be charged in accordance with the SFDS and that income verifications are performed at least annually. Cause: Based on audit procedures performed, the income verification process was not performed on an annual basis for patients to be charged the correct amount for their service. Effect: The lack of controls over the income verification process could cause revenue to be over or understated. The impact of the ten patients that did not have appropriate documentation is not able to be quantified. Recommendations: The established policies and controls did not operate effectively in these instances. Management should ensure processes are in place to make sure the income verification process is being performed annually for each patient.

Finding 2022-002 ? Sliding Fee Determination and Related Patient Billing U.S. Department of Health and Human Services Assistance Listing No. 93.224, Consolidated Health Centers Program Cluster Condition: As part of our compliance testing procedures for the HRSA 330 grant programs, we tested sixty patients billed under a sliding fee discount schedule. Of the patients tested, ten patients (16%) were found to have exceptions as the income verification was either not performed or had not been performed within the past 12 months. Criteria: All section 330-funded health centers must prepare and apply a sliding fee discount schedule (SFDS), which adjust amount owed for health center services by eligible patients based on the patient?s ability to pay. Management is responsible to make sure controls are in place for patients to be charged in accordance with the SFDS and that income verifications are performed at least annually. Cause: Based on audit procedures performed, the income verification process was not performed on an annual basis for patients to be charged the correct amount for their service. Effect: The lack of controls over the income verification process could cause revenue to be over or understated. The impact of the ten patients that did not have appropriate documentation is not able to be quantified. Recommendations: The established policies and controls did not operate effectively in these instances. Management should ensure processes are in place to make sure the income verification process is being performed annually for each patient.

Finding 2022-002 ? Sliding Fee Determination and Related Patient Billing U.S. Department of Health and Human Services Assistance Listing No. 93.224, Consolidated Health Centers Program Cluster Condition: As part of our compliance testing procedures for the HRSA 330 grant programs, we tested sixty patients billed under a sliding fee discount schedule. Of the patients tested, ten patients (16%) were found to have exceptions as the income verification was either not performed or had not been performed within the past 12 months. Criteria: All section 330-funded health centers must prepare and apply a sliding fee discount schedule (SFDS), which adjust amount owed for health center services by eligible patients based on the patient?s ability to pay. Management is responsible to make sure controls are in place for patients to be charged in accordance with the SFDS and that income verifications are performed at least annually. Cause: Based on audit procedures performed, the income verification process was not performed on an annual basis for patients to be charged the correct amount for their service. Effect: The lack of controls over the income verification process could cause revenue to be over or understated. The impact of the ten patients that did not have appropriate documentation is not able to be quantified. Recommendations: The established policies and controls did not operate effectively in these instances. Management should ensure processes are in place to make sure the income verification process is being performed annually for each patient.