Finding 1089087 (2024-003)

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Requirement
N
Questioned Costs
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Year
2024
Accepted
2024-12-02

AI Summary

  • Core Issue: The sliding scale assessment for patient billing was not applied correctly for some patients.
  • Impacted Requirements: This violates 42 CFR Part 51c.303 (f) regarding proper billing practices.
  • Recommended Follow-Up: Implement additional checks and balances to prevent future billing errors.

Finding Text

Sliding Scale Assessment Billing DEPARTMENT OF HEALTH AND HUMAN SERVICES ALN #: 93.224 Federal Award Identification #: H80CS6674 Condition: The sliding scale assessment based on a patient's ability to pay was not always applied properly for patient’s billing. Criteria: 42 CFR Part 51c.303 (f) Questioned Costs: $-0- Context: Out of 31 patients tested that had a sliding scale assessment, 3 patients had the correct sliding fee assessment completed; however, for the visit tested, the billing did not reflect the correct sliding fee. Cause: Human error. Effect: Non-compliance with federal regulations. Identification as repeat finding, if applicable: Not applicable. Recommendation: We recommend LACHC implement additional checks and balances for patient billing to prevent sliding fee billing errors. Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. See corrective action plan.

Categories

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Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.224 Community Health Centers $5.13M
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $383,837
93.527 Covid-19 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $49,392
32.006 Covid-19 Telehealth Program $47,219