Federal Assistance Listing No. 93.224 Health Center Program Cluster Award #: H80CS26510, Award year: March 1, 2023 – February 29, 2025, extended to February 28, 2026 U.S. Department of Health and Human Services Criteria: Special Tests and Provision: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR sections 51c.303(g); and 42 CFR sections 56.303 (f)) Condition: Patients received a sliding fee discount that was inconsistent with the stated sliding fee discount categories under the Organization’s policy. Questioned Costs: None Context: A sample of 25 encounters out of a population of 6,030 encounters were tested and 2 errors were noted where patients received an incorrect sliding fee adjustment. The sampling methodology used is not and is not intended to be statistically valid. Two patients received a sliding fee adjustment that was inconsistent with the approved policy for the proper sliding fee adjustments based on their income documentation. Effect: Sliding fee discounts were given to patients that were inconsistent with the Organization’s sliding fee discount policy. Cause: The Organization did not comply with their sliding fee policy. Identification as a repeat finding: Not a repeat finding. Recommendation: We recommend management continue to ensure all personnel understand the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Procedures should be implemented to ensure that eligible patients receive discounts in accordance with the sliding fee scale. CLIENT PLANNED ACTION: A new integrated EHR was implemented and will standardize and improve the accuracy and consistency of Sliding Fee Discount data entry, streamline training, auditing and compliance activities related to the Sliding Fee Discount Program going forward. In direct response to this finding related to the dental program, supplemental training has been developed to enhance existing programs. Dental front desk and billing staff will complete this required training by end of January 2026. Quarterly internal audits of the Sliding Fee Discount Program are conducted in the new EHR by the Director of Reimbursement, sampling all CHC locations with dental encounters included each time. Results are used to track compliance trends and trigger targeted training or oversight for locations or staff to ensure eligible patients receive appropriate income-based discounts. CLIENT RESPONSIBLE PARTY: JC Carrica III, Chief Administrative Officer (CAO) COMPLETION DATE: • Sliding Fee Discount Program quarterly audits – ongoing. • Identified staff will complete the specialized training session by January 31, 2026.