Finding Text
Finding 2022-002 – Special Tests & Provisions
Federal program and specific federal award
U.S. Department of Health and Human Services (HHS)
93.224 Consolidated Health Centers (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, Public Housing Primary Care, and School Based Health Centers); (HHS Community Health Center Program)
Type of Finding: Compliance and significant deficiency in internal control over compliance
Specific requirement-criteria
Health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patients’ ability to pay.
Condition-context
During a sample of sixty patient encounter visits; we noted the following errors: 1) two encounter visits were provided a sliding fee; however, both did not have the applicable sliding fee application and the sliding fee was applied to their patient account; 2) three encounter visits that qualified for a Homeless patient adjustment to zero were provided a sliding fee adjustment and, accordingly, the patient account was not slid to zero; and 3) a sliding fee adjustment applied to a patient’s account was applied at the incorrect amount per the Association’s sliding fee scale.
Cause
Due to the employee turnover within the front desk and the finance department, the Organization has had difficulty in training and assuring skilled intake staff are correctly applying the sliding fees.
Effect or potential effect
Applicants assessed are not charged according to the Association’s sliding fee scale and ability to pay.
Questioned costs
None.
Repeat finding
Yes, see finding 2021-003.