Finding 1081965 (2024-001)

Finding 2024 001: Sliding Fees Program Title: Health Center Cluster Assistance Listing Number: 93.224 Federal Award Year: June 1, 2023 to May 31, 2024 Federal Agency: U.S. Department of Health and Human Services 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 patient’s ability to pay. Condition Wipfli LLP tested 40 sliding fee transactions to verify if the amount charged was calculated properly based on the patient's income level and in compliance with Lakeshore Community Health Care, Inc.’s sliding fee policy. Wipfli LLP noted that one of the sampled transactions was not properly determined resulting in the patient being undercharged for services. Questioned Costs Undetermined. Cause and Effect Lakeshore Community Health Care, Inc. did not properly follow its policies for documenting and calculating charges for services when using the sliding fee scale. Patients may be charged the improper amount if proper procedures and controls are not in place to ensure the sliding fee is applied in accordance with Lakeshore Community Health Care, Inc.’s sliding fee policy. Auditor’s Recommendation Review policies and implement and monitor controls surrounding the determination of the fees charged to patients to determine that fees are being determined in accordance with Lakeshore Community Health Care, Inc.'s sliding fee policy. View of Responsible Officials Management agrees with the findings and has committed to a corrective action plan.