Finding 1206035 (2025-001)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2025
Accepted
2026-04-07
Audit: 397880
Organization: Tyler Family Circle of Care (TX)

AI Summary

  • Core Issue: One patient was incorrectly assessed a sliding fee discount, leading to lower payments than required.
  • Impacted Requirements: Compliance with federal regulations on sliding fee schedules based on family size and income.
  • Recommended Follow-Up: Increase self-reviews of patient encounters and enhance training for front desk staff on patient information verification.

Finding Text

Program Name/ALN Title: Health Center Cluster Federal Assistance Listing Number: 93.224/93.527 Federal Agency: U.S. Department of Health and Human Services Award Period: 6/1/2024 – 5/31/2025, 6/1/25-5/31/26 Criteria: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The organization assessed one patient with an incorrect sliding fee discount based on their family size and income documentation. Context: One (1) of forty (40) transactions selected for testing. In the one instance, the organization collected less patient payments then they were entitled to. Cause: Oversight. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their associated family size and income. Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Views of the Responsible Officials: There is no disagreement with the audit finding.

Corrective Action Plan

Health Center Program – Assistance Listing No. 93.224 Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: This appears to be a user error where a front desk staff member did not adequately review and input the patient’s information into our EPIC EMR system. We will continue to provide training to our front desk staff to ensure that applications are reviewed in detail and accurate patient information is entered into our systems. We will emphasize that all clinic managers must review SFS applications on a daily basis to verify that the correct slides are entered for each patient. Name(s) of the contact person(s) responsible for corrective action: Jennifer A. Breedlove Planned completion date for corrective action plan: March 31, 2026

Categories

Internal Control / Segregation of Duties

Other Findings in this Audit

  • 1206036 2025-002
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.217 FAMILY PLANNING SERVICES $291,638
93.224 HEALTH CENTER PROGRAM $201,638
93.898 CANCER PREVENTION AND CONTROL PROGRAMS FOR STATE, TERRITORIAL AND TRIBAL ORGANIZATIONS $169,424
93.527 GRANTS FOR NEW AND EXPANDED SERVICES UNDER THE HEALTH CENTER PROGRAM $18,035
93.994 MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT TO THE STATES $13,279