Finding 1102817 (2024-004)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2024
Accepted
2025-03-10

AI Summary

  • Core Issue: Some patients were charged less than they should have been due to errors in applying the sliding fee scale.
  • Impacted Requirements: Health centers must accurately apply sliding fee discounts based on patients' ability to pay, as mandated by ALN 93.224.
  • Recommended Follow-Up: Enhance the review process for billing information to prevent future errors in fee application.

Finding Text

Criteria: Health centers that receive funding under ALN 93.224 – Health Center Program, are required to prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted based on the patient’s ability to pay. Condition: During testing of the application of the Network’s slide scale fees, we noticed that 4 out of 71 testing selections applied a fee that was lower than the slide for which the patient qualified. Cause: In one of the four exceptions, there was an incorrect recording of the patient’s income on the slide determination documentation. The other three exceptions were due to the wrong slide being applied to a patient’s account where the slide-level qualifications had been properly documented. Effect: The pervasiveness and amount of these errors were projected to the entire population resulting in an estimated $1,895 which sliding patients were undercharged. Recommendation: We recommend that the Network implement a more robust review process for information that is input into the billing system. Auditor’s Conclusion: Because the amount of the error is trivial to the major program, this finding does not constitute a material weakness but is a control deficiency that requires attention to strengthen the accuracy of the application of the slide scale fees.

Categories

Material Weakness Internal Control / Segregation of Duties

Other Findings in this Audit

  • 526375 2024-004
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.224 Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.57M
93.913 Grants to States for Operation of State Offices of Rural Health $73,032
93.527 Grants for New and Expanded Services Under the Health Center Program $16,105