Finding 1169433 (2025-001)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2025
Accepted
2026-01-16

AI Summary

  • Core Issue: The sliding scale assessment for patient billing was not applied correctly, leading to potential billing errors.
  • Impacted Requirements: Compliance with 42 CFR Part 51c.303 (f) regarding proper documentation and application of sliding scale assessments.
  • Recommended Follow-Up: Implement additional checks for billing accuracy and ensure all documentation is retained to avoid future errors.

Finding Text

Sliding Scale Assessment Billing Significant Deficiency U.S. Department of Health and Human Services ALN #: 93.224 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) Federal Award Identification #: H80CS6674 Condition: The sliding scale assessment based on a patient's ability to pay was not always applied properly for patient’s billing. Additionally, the sliding scale assessment documentation was not always retained to support patient's billing. Criteria: 42 CFR Part 51c.303 (f) Questioned Costs: $0 Context: Out of 40 patients tested that had a sliding scale assessment, 38 patients had the correct sliding fee assessment completed; however, for the visit tested, the billing did not reflect the correct sliding fee. Additionally, 2 patients did not have proper documentation retained for the sliding fee assessment completed. Cause: Human error. Effect: Non-compliance with federal regulations. Identification as repeat finding, if applicable: Yes, 2024-003 Recommendation: We recommend LACHC implement additional checks and balances for patient billing and ensure all supporting documentation be retained to prevent sliding fee billing errors. Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. See corrective action plan.

Corrective Action Plan

Sliding Scale Assessment Billing Planned Corrective Action: Clinic management will implement additional checks and balances to ensure that Sliding Fee Application Forms and written income verification documentation are included in patients’ records and agree to the sliding fee level maintained in the electronic health records system. The Revenue Cycle Manager will increase the level of monitoring of required documentation of sliding fee levels used in billing patient charges. Person Responsible for Corrective Action Plan: Steonée Laskey, Chief Operations Officer Anticipated Date of Completion: January 31, 2026

Categories

HUD Housing Programs Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.224 HEALTH CENTER PROGRAM (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, AND PUBLIC HOUSING PRIMARY CARE) $4.71M
93.527 GRANTS FOR NEW AND EXPANDED SERVICES UNDER THE HEALTH CENTER PROGRAM $408,187