Finding 12864 (2022-002)

Significant Deficiency Repeat Finding
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-03-30
Audit: 17094
Organization: Partnership Health Center (MT)
Auditor: Kcoe Isom LLP

AI Summary

  • Core Issue: The center misapplied its sliding fee scale policy, leading to improper documentation and incorrect discounts for some patients.
  • Impacted Requirements: Compliance with the Health Center Program Compliance Manual's procedures for assessing patient income and family size.
  • Recommended Follow-Up: Review and update policies, and provide ongoing training for staff involved in sliding fee scale assessments.

Finding Text

#2022-002 ? Misapplication of the Sliding Fee Scale (repeat finding), AL #93.224 and AL #93.527 Condition: The center did not properly follow its sliding fee scale policy and procedures for patients that applied for a sliding fee discount and did not properly maintain documentation to support qualifications and the sliding fee discount received. Criteria: The Health Center Program Compliance Manual requires a health center to have operating procedures for assessing and re-assessing all patients for income and family size consistent with approved sliding fee discount program policies. Effect: No material noncompliance or questioned costs were noted in the period under audit. Context: Our testing detected 11 out of 60 patients selected for testing either did not have proper documentation to support their qualification of the sliding fee discount received or received an incorrect discount. Cause: Inconsistent application of the policies and procedures approved by the Center. Recommendation: We recommend the Center review its current policies and procedures and continue to provide training to all staff members handling the sliding fee scale assessments to ensure assessments are performed in accordance with policy. Management?s Response to Finding:

Corrective Action Plan

Condition: The Center did not properly follow its sliding fee scale policy and procedures for patients that applied for a sliding fee discount and did not properly maintain documentation to support qualifications and the sliding fee discount received. Criteria: The Health Center Program Compliance Manual requires a health center to have operating procedures for assessing and re-assessing all patients for income and family size consistent with approved sliding fee discount program policies. Management Response to Findings: As an FQHC, the Center is required to have operating procedures for assessing and re-assessing patients for sliding fee discounts. During FY2021, the Center identified system limitations that made the sliding fee discount program application ineffective. In response to the limitations, the Center implemented a different sliding fee discount structure on April 1, 2022, in FY2022, and continued internal audits to review the application of current policies and procedures. The Center acknowledges that the sliding fee scale workflow resides in two departments, and current structures and processes are ineffective in the handling and correction of deficiencies. The Center hired two people with direct duties of setting the sliding fee scale assessments. These focused work duties will increase the accuracy and efficiencies of setting the assessments. Timing of corrective action: As of April 1, 2022, the Center has simplified the sliding fee discount structure to address system-generated errors in discount application. As of September 30, 2022 the Center has implemented an improved structure for sliding fee scale training and assessment. As of January 2023 the Center hired two people with focused work duties for setting sliding fee scale assessments. As of March 2023 the Center has enhanced internal audit procedures in place. Contact: Bryan Chalmers, Chief Finance Officer, Partnership Health Center, 401 Railroad Street W., Missoula, MT 59802; chalmersb@phc.missoula.mt.us, (406)258-4445

Categories

No categories assigned yet.

Other Findings in this Audit

  • 12865 2022-002
    Significant Deficiency Repeat
  • 589306 2022-002
    Significant Deficiency Repeat
  • 589307 2022-002
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $3.27M
93.566 Refugee and Entrant Assistance_state Administered Programs $211,169
93.495 Community Health Workers for Public Health Response and Resilient $156,968
93.917 Hiv Care Formula Grants $139,233
93.461 Covid-19 Testing for the Uninsured $115,459
93.969 Pphf Geriatric Education Centers $100,000
21.027 Coronavirus State and Local Fiscal Recovery Funds $93,675
93.665 Emergency Grants to Address Mental and Substance Use Disorders During Covid-19 $91,192
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $79,227
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $76,625
93.940 Hiv Prevention Activities_health Department Based $47,203
93.884 Grants for Primary Care Training and Enhancement $24,585
93.070 Environmental Public Health and Emergency Response $20,949
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $5,726
93.426 Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke $4,609
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $4,542
93.435 Innovative State and Local Public Health Strategies to Prevent and Manage Diabetes and Heart Disease and Stroke- $3,497
93.268 Immunization Cooperative Agreements $2,505
14.231 Emergency Solutions Grant Program $137