Finding Text
Information on the federal program – Assistance Listing Number 93.224/93.527; Health Center Program Cluster; Department of Health and Human Services Criteria or specific requirement – Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. Condition – During our review of the Organization’s sliding fee calculations, we noted 3 patient accounts with incorrectly calculated sliding fee adjustments. Cause – The Organization did not have internal controls in place to ensure that the correct sliding fee adjustment was applied to patient accounts. Effect or potential effect – Patients received incorrect sliding fee adjustments resulting in an incorrect patient responsibility. Questioned costs – None Context – Out of a population of 43,633 patient accounts receiving sliding fee adjustments, a sample of 25 patient accounts were selected for testing, and 3 accounts had an incorrect sliding fee adjustment calculation. The sample was not statistically valid. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – We recommend the Organization establish an internal control procedure to ensure that sliding fee adjustments are correctly calculated and reviewed. Views of responsible officials and planned corrective actions – Management acknowledged the sliding fee adjustment errors resulted from manual adjustments made within the electronic health record system. Management will add an additional layer of review over manual adjustments. Further, the Organization will implement a process to periodically review sliding fee adjustments throughout the year for accuracy.