Finding 1164221 (2025-001)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2025
Accepted
2025-12-09

AI Summary

  • Core Issue: Health Centers are not applying sliding fee discounts correctly, leading to improper discounts for patients based on their income.
  • Impacted Requirements: Compliance with Uniform Guidance and 42 CFR regulations regarding sliding fee discounts is not being met.
  • Recommended Follow-Up: Train staff on accurate discount application and ensure supervisory reviews of sliding fee applications to prevent future errors.

Finding Text

Finding: 2025-001 Sliding Fee Discounts Federal Programs: Department of Health and Human Services Health Center Program Cluster Assistance Listing No. 93.224 and 93.527 Criteria: Uniform Guidance, Special Tests & Provisions, Sliding Fee Discounts, 42 CFR, 56.303 Condition: Health Centers receiving funding under the Health Center Program Cluster must prepare and apply a sliding fee discount so that the amounts owed for health center services by eligible patients are discounted based on the patient’s ability to pay. During compliance testing the following errors were noted: • 3 patients were given discounts when applications were incomplete or expired • 1 patient who qualified for discounts was given an incorrect discount • 4 patients with incomes greater than 200% poverty were given discounts • 1 patient with income less than 200% poverty was not given a discount Cause: There were deficiencies in internal controls designed to ensure that proper sliding fee discounts were applied to patient accounts in accordance with the Organization’s sliding fee scale. The sliding fee scale file was not properly utilized in the application of discounts provided to certain patients. Effect: Discounts were not properly applied to patient accounts. Questioned Costs: None reported. Context/Sampling: For 9 of 48 self-pay patients selected for testing, applications were incomplete or expired or incorrect discounts were given. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: Yes Recommendation: It is recommended that staff be trained to review sliding fee discounts applied to ensure they are accurate and that proper documentation is obtained. In addition, it is recommended that supervisory level personnel select and review a sample of sliding fee applications and discounts to ensure that staff are properly applying the discounts. Views of Responsible Officials: Management concurs. Efforts will be made to implement corrective actions as recommended above. Contact Person: Shantelle Simpson, President & CEO Anticipated Date of Completion: January 31, 2026

Corrective Action Plan

In Finding 2025-001, it was reported that the Organization did not properly apply the sliding fee discounts for certain patients with visits to the Organization during the year ended June 30, 2025. Management recognizes the importance of complying with sliding fee guidelines and the Organization’s sliding fee policy. In response to Finding 2025-001, proper training will be given to employees, and sliding fee discounts will be reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee policy.

Categories

Special Tests & Provisions Internal Control / Segregation of Duties

Other Findings in this Audit

  • 1164220 2025-001
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.224 CONSOLIDATED HEALTH CENTERS (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, AND PUBLIC HOUSING PRIMARY CARE) $2.13M
93.211 TELEHEALTH PROGRAMS $113,993
93.912 RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH NETWORK DEVELOPMENT AND SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT $72,511
93.527 AFFORDABLE CARE ACT (ACA) GRANTS FOR NEW AND EXPANDED SERVICES UNDER THE HEALTH CENTER PROGRAM $36,425
93.959 BLOCK GRANTS FOR PREVENTION AND TREATMENT OF SUBSTANCE ABUSE $17,118
10.766 COMMUNITY FACILITIES LOANS AND GRANTS $14,990