Finding Text
U.S. Department of Health and Human Services Health Center Program Cluster - Health Center Program, Assistance Listing No. 93.224 Compliance Requirements: Special Tests and Provisions Type of Finding: Material Noncompliance and Material Weakness in Internal Control over Compliance (Repeat Finding) Condition - Proper backup of sliding fee applications and supporting income level documents were not maintained or stored. Criteria - Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards ("Uniform Guidance") requires that a non-federal entity 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. Cause - The Center did not have internal controls to reasonably ensure compliance. Effect - Patients were potentially incorrectly given or not given proper sliding fee discounts. Context - A nonstatistical sample of 60 from a population of over 250 encounters was selected for testing. The proper supporting documents were not maintained or the appropriate sliding fee discount was improperly applied for 7 encounters tested. The sample was not intended to be, and was not a statistically valid sample. Questioned Costs - None Recommendation - We recommend the Center implement internal controls to reasonably ensure its compliance with the requirements identified in Uniform Guidance. Management Response to Findings - Management concurs with the finding.