Finding 12401 (2022-001)

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Requirement
L
Questioned Costs
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Year
2022
Accepted
2023-06-29

AI Summary

  • Core Issue: Net Charges from Patient Care were inaccurately reported in the PRF Period 2 submission due to transposition errors among payer classifications.
  • Impacted Requirements: Reporting entities must accurately submit revenues by payer mix for the specified period, affecting compliance with grant requirements.
  • Recommended Follow-Up: Implement a second level of review to ensure accuracy in future PRF Reporting Portal submissions.

Finding Text

2022-001 Provider Relief Fund Lost Revenue Payor Classification Cluster: Not applicable Grantor: Health Resources and Services Administration Award Names: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Award Year: PRF Period 2 Period of Availability from January 1, 2020 to December 31, 2021 Award Number: Not applicable Assistance Listing Numbers: 93.498 Criteria Reporting entities were required to submit revenues/net charges from patient care (prior to netting with expenses) incurred within the period of availability, by payer mix (including out of pocket charges), and by quarter for each quarter during the period of availability up to June 30, 2023, the end of the quarter in which the Public Health Emergency ends. Condition As we were performing our lost revenue tie out procedures, we noted the Net Charges from Patient Care by Payer (?Net Charges?) were inaccurately reported in the PRF Period 2 Reporting Portal Submission. More specifically, the System transposed the referenced Net Charges in the `Total Revenue/Net Charges from Patient Care (2021 Actuals)? table by the following: ? For Q2 (2021), the System understated the Medicaid/Children?s Health Insurance Program (CHIP) payer and overstated the Commercial Insurance payer Net Charges by $2,222,668. ? For Q3 (2021), the System understated Medicaid/Children?s Health Insurance Program (CHIP) by $973,100, understated Commercial Insurance by $289,399, and overstated Self-Pay (No Insurance) by $1,262,499. ? For Q4 (2021), the System understated Medicaid/Children?s Health Insurance Program (CHIP) by $411,383, understated Commercial Insurance by $99,064, and overstated Self-Pay (No Insurance) by $510,447. As Net Charges were transposed between payers, there was no impact to the total revenue and lost revenue calculation reported in the PRF Period 2 Reporting Portal Submission. Cause Management did not have a control in place to perform a second level of review to check the accuracy of the reporting at the time of completing the PRF Period 2 Reporting Portal submission. Effect Net Charges from Patient Care by Payer for were inaccurately reported in the PRF Period 2 Reporting Portal Submission. Questioned Costs None identified. Recommendation We recommend that management implement a second level of review over the PRF Reporting Portal submissions. Management?s Views and Corrective Action Plan Management?s Views and Corrective Action Plan are included at the end of this report after the summary schedule of prior audit findings and status.

Corrective Action Plan

2022-001 Provider Relief Fund Lost Revenue Payor Classification Cluster: Not applicable Grantor: Health Resources and Services Administration Award Names: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Award Year: PRF Period 2 Period of Availability from January 1, 2020 to December 31, 2021 Award Number: Not applicable Assistance Listing Numbers: 93.498 Management?s Views and Corrective Action Plan Management?s View Management agrees with the Auditors? assessment of the System?s internal controls over compliance in regards to the Provider Relief Fund Lost Revenue by Payor Classification during the Period 2 reporting session covering January 1, 2020 through December 31, 2021. Net Charges from Patient Care by Payer (?Net Charges?) were transposed in the PRF Period 2 Reporting Portal Submission. Management believes there was no impact to the total revenue and lost revenue calculation reported in the PRF Period 2 Reporting Portal Submission. Corrective Action Plan Provider Relief Fund reports are cumulative. To correct this payor misclassification, Management intends to present the correct cumulative total on the Period 5 reporting portal covering January 1, 2020 through June 30, 2022, as Period 3 and Period 4 were not applicable to the System. Further, Management will create a formal review process whereby payer classification will be verified by an individual other than the preparer as part of the Period 5 reporting procedures. Responsible Official: Ross Replogle, Corporate Controller Expected Completion Date: September 30, 2023

Categories

Reporting

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $37.00M
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $8.95M
21.019 Coronavirus Relief Fund $1.01M
32.006 Covid-19 Telehealth Program $996,406
93.461 Hrsa Covid-19 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $468,425
21.027 Coronavirus State and Local Fiscal Recovery Funds $320,000