Finding 1147116 (2024-001)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2024
Accepted
2025-07-08

AI Summary

  • Core Issue: Two patient encounters were charged less than the approved nominal fee due to the sliding fee schedule not being updated in the EMR system.
  • Impacted Requirements: The Organization did not properly update the board-approved sliding fee schedule, leading to incorrect fee applications for certain encounters.
  • Recommended Follow-Up: Review and strengthen internal controls annually to ensure the sliding fee scale is updated correctly in the EMR system.

Finding Text

SPECIAL TESTS AND PROVISIONS Federal Agency: Department of Health and Human Services Federal Program or Cluster: Health Center Program Cluster Assistance Listing Number: 93.224 Federal Award Numbers and Years Award Period 6/1/23-5/31/24: 5 H80CS24133-12-00 Award Period 6/1/24-5/31/25: 6 H80CS24133-13-02 Questioned Costs $0 Condition: During our testing of applied sliding fee discounts, twenty-five patient encounters were tested. Of those encounters, we identified two encounters that were charged less than the approved nominal fee due to the nominal fee amount not being updated in the electronic medical record ("EMR") system. Criteria: The Organization failed to update the board approved sliding fee schedule in its EMR system, resulting in an incorrect nominal fee being applied to certain income level behavior health encounters. Cause: Employees missed updating and raising this fee when the new sliding scale was approved. Effect: The Organization received a lower fee for services than it could have based on the approved schedule. Recommendation: We recommend the Organization review internal controls over updates to its sliding fee scale each year to ensure it is properly updated. Identification of repeat findings: This is not a repeat finding. View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding, has updated fees in the electronic medical record ("EMR"), made sure that they match approved nominal fees, and will make sure they are in alignment prospectively.

Categories

Special Tests & Provisions Internal Control / Segregation of Duties

Other Findings in this Audit

  • 570673 2024-001
    Significant Deficiency
  • 570674 2024-001
    Significant Deficiency
  • 570675 2024-001
    Significant Deficiency
  • 570676 2024-002
    Material Weakness
  • 570677 2024-003
    -
  • 1147115 2024-001
    Significant Deficiency
  • 1147117 2024-001
    Significant Deficiency
  • 1147118 2024-002
    Material Weakness
  • 1147119 2024-003
    -

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) $243,025
93.526 Grants for Capital Development in Health Centers $229,684
21.027 Coronavirus State and Local Fiscal Recovery Funds $41,319
93.527 Grants for New and Expanded Services Under the Health Center Program $30,783
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $19,281
14.218 Community Development Block Grants/entitlement Grants $5,325