Finding 1168640 (2024-004)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2024
Accepted
2026-01-09

AI Summary

  • Core Issue: Patients received sliding fee discounts that did not match the Organization's policy categories.
  • Impacted Requirements: Non-compliance with the sliding fee discount policy as outlined in federal regulations.
  • Recommended Follow-up: Management must ensure proper application of sliding fee adjustments based on policy and patient eligibility.

Finding Text

Federal Assistance Listing Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award No. 6 H80CS28372-10-01 Program Year 2024 Criteria or Specific Requirement – Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR sections 51c.303(g) and 42 CFR section 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. Cause –The Organization did not comply with their sliding fee discount policy. Effect or potential effect – Sliding fee discounts were given to patients that were inconsistent with the Organization’s sliding fee policy. Questioned costs – None Context – A sample of 40 patient encounters was tested out of the population of 8,900 patient encounters. The sample is not, and is not intended to be, statistically valid. Of the 40 patient encounters tested, two were determined to have resulted in an improper sliding fee adjustment based on the Organization’s policy and screening of patient eligibility. Identification as a repeat finding – Repeat finding, see prior year finding number 2023-004. Recommendation – Management should ensure that sliding fee adjustments are properly applied in accordance with the sliding fee policy and patient eligibility.

Corrective Action Plan

Community Health Center in Cowley County, Inc. acknowledges the repeat finding regarding application of sliding fee discounts. To address this, we have: • Continued weekly meetings between frontline staff and the billing/revenue department to reinforce policy alignment. • Enhanced and formalized training programs for all staff involved in eligibility screening and discount application. • Updated our Financial and Sliding Fee policies to clarify procedures and eligibility criteria. These actions are part of our ongoing commitment to improving internal controls and ensuring compliance with federal program requirements. Effectiveness will be monitored through periodic audits and staff feedback.

Categories

Special Tests & Provisions Eligibility

Other Findings in this Audit

  • 1168635 2024-003
    Material Weakness Repeat
  • 1168636 2024-004
    Material Weakness Repeat
  • 1168637 2024-003
    Material Weakness Repeat
  • 1168638 2024-004
    Material Weakness Repeat
  • 1168639 2024-003
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.527 GRANTS FOR NEW AND EXPANDED SERVICES UNDER THE HEALTH CENTER PROGRAM $999,446
93.526 GRANTS FOR CAPITAL DEVELOPMENT IN HEALTH CENTERS $510,722
93.391 ACTIVITIES TO SUPPORT STATE, TRIBAL, LOCAL AND TERRITORIAL (STLT) HEALTH DEPARTMENT RESPONSE TO PUBLIC HEALTH OR HEALTHCARE CRISES $228,899
93.224 HEALTH CENTER PROGRAM (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, AND PUBLIC HOUSING PRIMARY CARE) $35,316