Finding Text
Finding 2022-006
Compliance Requirement: Special Tests and Provisions-Sliding Fee Discounts
Type of Finding: Material Weakness
Criteria: Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient’s ability to pay and their eligibility. A patient’s eligibility to pay is determined on the basis of the official poverty guidelines.
Condition and Context: Supporting documents could not be located for six of the twenty-five patients selected for testing. As such, we were unable to determine eligibility for those patients.
Cause: The condition can be attributed to turnover in patient management personnel and the fact that various files were moved off-stie and stored without adequate communication to incoming personnel.
Effect: Sliding fee discounts given could potentially be incorrect, or the patient could be ineligible.
Questioned Costs: None
Repeat Finding: Yes
Recommendation: The Organization should be implementing and monitoring procedures to ensure that all supporting documents are kept for determining patient eligibility.
Management’s Response: Management agrees with the finding.