Finding Text
2022-005: U.S. Department of Health and Human Services
Health Center Program Cluster- Health Center Program, Assistance Listing No. 93.224
Compliance Requirements: Special Tests and Provisions
Type of Finding - Significant Deficiency in Internal Control over Compliance (Repeat Finding)
Condition - Proper backup of sliding fee applications and supporting income level documents were not maintained or stored.
Criteria - Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) requires that a non Federal entity prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay.
Cause - The Organization did not have internal controls to reasonably ensure compliance.
Effect - Patients were potentially incorrectly given or not given proper sliding fee discounts.
Context - A non statistical sample of 40 from a population of over 250 encounters was selected for testing. The proper supporting documents were not maintained for 6 encounters tested.
Recommendation - We recommend the Organization implement internal controls to reasonably ensure its compliance with the requirements identified in Uniform Guidance.
Management Response to Findings – Management concurs with the finding.