Finding 24321 (2022-001)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2022-10-24
Audit: 22121
Organization: Mountain Famly Health Centers (CO)

AI Summary

  • Core Issue: Incorrect sliding fee discounts were applied to two patient visits, potentially affecting patient charges.
  • Impacted Requirements: Compliance with Title 42 regulations requiring accurate fee schedules and discounts based on patient ability to pay.
  • Recommended Follow-Up: Review and improve internal controls for the sliding fee process; management will retrain staff to ensure correct application of fees and timely updates.

Finding Text

Criteria Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition Found and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified two visits that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials and Planned Corrective Actions Management has accepted the recommendations and has scheduled time at bi-weekly front desk/billing meetings to retrain staff on processes that ensure appropriate sliding fee rates are utilized for each sliding fee encounter. Specifically, training will focus on confirming fee schedules are updated on a timely basis per the effective date of the fee change, and encounters with both an office visit and procedure are properly identified so that the procedure co-pay is adjusted off in entirety, leaving only the office visit co-pay as the patient responsibility.

Categories

Internal Control / Segregation of Duties Subrecipient Monitoring

Other Findings in this Audit

  • 24320 2022-001
    Significant Deficiency
  • 24322 2022-001
    Significant Deficiency
  • 24323 2022-001
    Significant Deficiency
  • 600762 2022-001
    Significant Deficiency
  • 600763 2022-001
    Significant Deficiency
  • 600764 2022-001
    Significant Deficiency
  • 600765 2022-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act for New and Expanded Services $2.63M
93.224 Covid-19: American Rescue Plan Act for Health Centers $2.49M
93.498 Covid-19: Provider Relief Fund - Phase 1 $1.04M
93.224 Consolidated Health Centers $908,096
93.224 Covid-19: Fy 2020 Expanding Capacity for Coronavirus Testing (ect) $133,570
21.027 Covid-19: Coronavirus State and Local Fiscal Recovery Funds $121,732
93.461 Covid-19: Hrsa Covid-19 Claims Reimbursement for the Uninsured Program and for the Covid-19 Coverage Assistance Funds $73,699
93.217 Family Planning Services $42,930
93.884 Grants for Primary Care Training and Enhancement $24,257