Finding Text
Finding required to be reported in accordance with Uniform Guidance. 2025-001 – SPECIAL TESTS AND PROVISIONS Identification of Federal Program U.S. Department of Health and Human Services 93.224 / 93.527 – Health Center Cluster Criteria – Health centers are required to maintain a schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility is determined on the basis of the official poverty guidelines, as revised by DHHS [42 CFR §§ 51c, 107(b)(5), 56.108(b)(5), and 56.303(f)]. Escambia Community Clinics, Inc. (ECC) should implement and monitor procedures to properly determine, calculate, and review sliding fee discounts to patients in accordance with ECC’s sliding fee scale. Condition – ECC did not maintain proper documentation to support the sliding fee discount applied to six of forty patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2025. Of these six instances, two resulted in the patient being charged an incorrect sliding fee discount. Cause – Policies and procedures were not consistently followed to ensure that the appropriate sliding fee discount was properly determined, documented and applied to all eligible patients. Effect or Potential Effect – ECC did not comply with the determination of sliding fee discounts based on federal poverty guidelines in effect for the year ended December 31, 2025. As a result, sliding fee discounts may not have been properly calculated, and the discount given, if any, may not have been based on the patient's ability to pay. Questioned Costs – None Repeat Finding – No Recommendation – We recommend that ECC continue to train and develop personnel on specific processes related to compliance requirements. In addition, ECC should establish a review process to ensure that sliding fee discounts are monitored and reviewed by a supervisor on a periodic basis to ensure compliance. Views of Responsible Officials See accompanying Corrective Action Plan