Finding Text
Criteria: In accordance with the Health Resources & Services Administration Health Center Program Compliance Manual, Chapter 9: Sliding Fee Discount Program, health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted based on the patients’ ability to pay.
Condition/Cause: The Organization had instances in which discounts were not applied accurately based on the underlying support that was provided by the patient.
Effect: Certain patients may have been billed amounts in excess of and less than the amounts defined by the sliding fee discount schedule.
Questioned Costs: Not applicable.
Context: We selected 40 patient visits out of the entire population of patients that may be eligible to receive benefits under the program during the fiscal year ended June 30, 2024. In 11 of the 40 samples tested, the patient did not receive the proper sliding fee scale discount per the Organization’s policy.
Repeat Finding: This is a repeat finding. See prior year finding 2023-002.
Recommendation: We recommend that further processes and training be put in place to ensure that the sliding fee scale is accurately applied to all qualifying program participants and applicable documentation is retained.
Views of Responsible Officials: The Organization concurs with the finding and is working on implementing the recommendation.