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Special Tests and Provisions - Sliding Fee Scale Discounts Federal program: FAL# 93.224 Health Centers Cluster: Health Center Program U.S. Department of Health and Human Services Federal grant number: 24H80CS00752 Questioned Costs: None Criteria: Patients applying for sliding fee scale (SFS) discounts should have their income levels adequately documented and accurately calculated, and patients should be given the proper discount based upon their income level in accordance with 42 CFR Section 51c.303(f). Condition: The Center requires patients that apply for the SFS discount to complete attestation forms that includes their household sizes and income levels, and these forms are then used to determine patients' SFS discounts. One SFS encounter that we tested had incorrectly calculated SFS discount applied in the patient management system. Cause: Unknown Effect: Due to incomplete attestation forms, we could not determine whether the Center consistently provided patients with the proper discount based upon their income levels, and internal controls over compliance requirements do not appear to have been operating effectively to detect calculation errors on attestation forms. Recommendation: To help ensure that SFS discounts are properly calculated and documented, the Center should perform random reviews of its SFS applications to detect and correct errors or incomplete applications on a timely basis.