Finding 1226263 (2025-001)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2025
Accepted
2026-08-11

AI Summary

  • Core Issue: Health centers failed to apply the correct sliding fee discounts for eligible patients based on their approved levels.
  • Impacted Requirements: Compliance with the sliding fee discount schedule under ALN 93.224 was not met, leading to incorrect billing.
  • Recommended Follow-Up: Implement a second-level review process for demographic and income data to ensure accurate financial classifications.

Finding Text

Federal Agency: U.S Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 Award Period: 1/1/2025 – 12/31/2026 Type of Finding: Significant Deficiency in Internal Control over Compliance and Compliance Criteria or specific requirement: Under the compliance requirement for Special Tests and Provisions for ALN 93.224, “health centers must prepare 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: Encounters eligible for a sliding fee adjustment did not receive the appropriate adjustment per the patient’s approved sliding fee discount level. Context: During our testing of sliding fee discounts for health center patients qualifying for reduced charge visits, we identified three visits in a sample of forty, which received the incorrect sliding fee discount. Cause: Internal control process and procedures were not followed resulting in a discount applied in the billing system that did not match the sliding fee determination per the approved patient application. Effect: Patient would receive an incorrect sliding fee discount. Recommendation: We recommend implementation of a second level independent review of the demographic data and income verification information entered into the patient billing system in order to ensure the financial classification is correct. Views of responsible officials: There is no disagreement with the audit finding.

Corrective Action Plan

Department of Health and Human Services: ParkTree Community Health Center (PCHC) respectfully submits the following corrective action plan for the year ended December 31, 2025. Audit period: 01/1/25 – 12/31/25 The findings from the schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the numbers assigned in the schedule. FINDINGS—FEDERAL AWARD PROGRAMS AUDITS Department of Health and Human Services 2025-01 Health Center Cluster– Assistance Listing No. 93.HCP Recommendation: CLA recommends that PCHC implement a second-level, independent review of demographic data and income verification information entered into the patient billing system to help ensure each patient’s sliding fee classification and corresponding discount is accurate. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Corrective Action Plan: ParkTree Community Health Center will implement a second-level independent review process for all new Sliding Fee Discount Program (SFDP) applications and annual renewals. Under this process, demographic information, household income documentation, family size, and the assigned sliding fee classification will be independently verified by a designated supervisor or other qualified staff member before the sliding fee discount is finalized in NextGen. Front desk receptionists and enrollment staff receive ongoing training and best practice reminders to ensure that all SFDP applications and supporting documentation are completed accurately and in a timely manner. Management has also implemented a weekly internal review process to verify that applications are complete, that appropriate supporting documentation is retained in each patient's file, and that assigned sliding fee classifications are accurate and consistent with PCHC's Board-approved SFDP policies and procedures. In addition, periodic quality assurance reviews will continue to be conducted to monitor compliance, identify trends, and provide corrective coaching when discrepancies are identified. These enhanced controls are designed to strengthen internal controls, improve compliance with the SFDP, and help ensure that each patient's sliding fee classification and corresponding discount are accurately applied in NextGen. Name of Contact Person Responsible for Corrective Action: Alfonso Aguilera Planned Completion Date: December 31, 2026 If the U.S Department of Health and Human Services has any questions regarding this Corrective Action Plan, please contact Alfonso Aguilera at (909)-865-9501, Ext. 3970.

Categories

Special Tests & Provisions Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 1226262 2025-001
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.493 CONGRESSIONAL DIRECTIVES $471,953
93.224 HEALTH CENTER PROGRAM $337,159
93.788 OPIOID STR $62,545