Finding 1154106 (2024-001)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2024
Accepted
2025-09-23

AI Summary

  • Core Issue: Improper application of the sliding fee discount schedule led to ineligible patients receiving discounts.
  • Impacted Requirements: Compliance with the sliding fee adjustment criteria under ALN 93.224/93.527 was not met.
  • Recommended Follow-Up: Provide additional training for staff on calculating and recording sliding fee adjustments to ensure compliance.

Finding Text

Program Name/ALN Title: Health Center Cluster Federal Assistance Listing Number: 93.224/93.527 Federal Identifying Numbers: H80CS00299-22, H80CS00299-23 Federal Agency: U.S. Department of Health and Human Services Award Period: 1/1/2024 – 12/31/2024 Type of Finding: Significant Deficiency Over Internal Control and Compliance Criteria: Under the compliance requirement for Special Tests and Provisions for ALN 93.224/93.527, “health centers must 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”. Condition: In two instances, the sliding fee adjustment was improperly applied to a patient’s account. Context: CLA identified two instances out of twenty-five tested of which the patient received a sliding fee adjustment when they did not meet the criteria for a sliding fee adjustment. Cause: The sliding fee application support was not assessed properly to where a patient received a sliding fee discount when they were not eligible. Effect: Patients received a sliding fee adjustment when they were not eligible. Questioned Costs: $0 Recommendation: It is recommended that the Agency provide additional training to staff on the calculation and recording of sliding fee adjustments to ensure sliding fee adjustments are correctly applied to all eligible patients. Views of the Responsible Officials: There is no disagreement with the audit finding.

Categories

Special Tests & Provisions Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 1154107 2024-001
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.527 Grants for New and Expanded Services Under the Health Center Program $135,222
93.224 Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $122,661
93.994 Maternal and Child Health Services Block Grant to the States $25,495