Finding Text
Federal Agency: U.S Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Award Period: 03/1/24-02/28/27 Type of Finding: Significant Deficiency in Internal Control over Compliance and Compliance Criteria or specific requirement: Per 42 USC 254b(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e),(f), and (g); the health and 42 CFR sections 56.303(e), (f), and (g) a health center must establish and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. Condition: Per La Pine Community Health Center’s sliding fee discount policy the determination of a patient’s eligibility for the program is determined based upon gross income. Context: During our testing of the sliding fee discount program, we identified six instances of 40 that were determined based upon a patient’s net income vs gross income. Cause: Process and procedures were not followed and the Organization’s internal control system failed to identify the wrong basis for program eligibility was used in the determination process. Effect: Potentially a patient would receive an incorrect determination and/or sliding fee discount. Recommendation: Management should review their sliding fee policy, refamiliarize personnel with the policy, and implement a secondary review process. Views of responsible officials: There is no disagreement with the audit finding.