Finding Text
2024 – 002 – Special Test and Provisions
Health Center Program & Grants for New and Expanded Services under the Health Center Program
Assistance Listing Number: 93.224 & 93.527
Federal Award ID Number:
H8004213
H8F41284
C1650401
H8G47667
H8L51683
H2E45573
Department of Health and Human Services
Funding 2024
Criteria: 42 CFR sections 51c.303 (f) requires that Brevard Health Alliance “have prepared a schedule of fees or payments for the provision of its services designed to cover its reasonable costs of operation and a corresponding schedule of discounts adjusted on the basis of the patient's ability to pay.”
The schedule of discounts must provide for a full discount to individuals and families with annual incomes at or below those set forth in the poverty guidelines updated periodically in the Federal Register by the U.S. Department of Health and Human Services under the authority of 42 U.S.C 9902(2); and for no discount to individuals and families with annual incomes greater than twice those set forth in such guidelines.
2 CFR 200.303 provides that non-Federal entities must establish and maintain effective internal controls to provide reasonable assurance of compliance with Uniform Guidance.
Condition: CRI selected a sample of 25 patients to ensure the sliding fee schedule was properly applied. 1 of the 25 patients had the incorrect fee scale applied.
Cause: The cause appears to be human error by an employee selecting the incorrect sliding fee scale. Identifying every manual input error is difficult, however, the Alliance performs an audit of the sliding fee schedule for thousands of patients on an annual basis.
Effect: Patients could be paying more or less than what is allowable based on the fee schedule. Questioned Cost: Undeterminable as the grant is not reimbursed based on patient fees.
Perspective: The issue appears isolated as it was a 4% failure rate (1 out of 25).
Recommendation: Procedures should be implemented to verify the sliding fee schedule applied to new patients.