Finding Text
III. FEDERAL AWARD FINDINGS AND QUESTIONED COSTS Finding 2022-001 Special Tests and Provisions ? Material Weakness in Internal Control over Compliance Program: U.S Department of Health and Human Services Health Center Program Cluster: ALN 93.22/93.527. Award Number: Various. Award Year: 2022, 2023. Criteria: In accordance with the Health Resources & Services Administration Health Center Program Compliance Manual, Chapter 9: Sliding Fee Discount Program, health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted based on the patients? ability to pay. Condition/Cause: The Health Center did not retain underlying data in accordance with policy to support the sliding fee scale discount based on the patients? family size or income. Additionally, the Health Center had instances in which discounts were not applied accurately based on the underlying support that was provided by the patient. The Health Center?s implementation of Epic during the prior year impacted the design and implementation of internal controls over the compliance with respect to the sliding fee discount. Effect: Certain patients may have been billed amounts in excess of and less than the amounts defined by the sliding fee discount schedule. Questioned Costs: Not applicable. Context: We selected 40 patient visits out of the entire population of patients that may be eligible to receive benefits under the program during the fiscal year ended March 31, 2022. In 16 out of 40 samples tested, the Health Center was unable to locate underlying support required per their policy. Repeat Finding: Not applicable. Recommendation: We recommend that further processes and training be put in place to ensure that the sliding fee scale is accurately applied to all qualifying program participants and applicable documentation is retained. Views of Responsible Officials: The Health Center concurs with the finding and is working on implementing the recommendation.