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.