Finding Text
Finding 2024-001 Special Tests and Provisions – Significant Deficiency in Internal Control over
Compliance
Program: U.S. Department of Health and Human Services
Health Center Program Cluster: ALN 93.224/93.527
Award Number: Various
Award Year: 2023, 2024
U.S. Department of Treasury
Coronavirus State and Local Fiscal Recovery Funds
ALN 21.027
Award year: 2022, 2023
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 Health Center 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 60 patient visits out of the entire population of patients that may
be eligible to receive benefits under the program during the fiscal year ended
March 31, 2024. In 2 of the 60 samples tested, the patient did not receive the
proper sliding fee scale discount per the Health Center’s policy. Additionally,
during our testing of Coronavirus State and Local Fiscal Recovery Funds,
ALN 21.027, we noted 1 instance in our testing in which the patient received
a sliding fee scale discount after declining the discount.
Repeat Finding: Not applicable.
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 Health Center concurs with the finding and is working on implementing
the recommendation.