Finding 25956 (2022-002)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-08-06
Audit: 24281
Auditor: Kcoe Isom LLP

AI Summary

  • Core Issue: Four errors were found in applying the sliding fee scale for patient billing.
  • Impacted Requirements: Consistent application of the sliding fee scale is essential to avoid funding loss and ensure equitable healthcare access.
  • Recommended Follow-Up: Strengthen internal controls by regularly monitoring patient eligibility and reviewing claims before billing.

Finding Text

#2022-002 Sliding Fee Scale; AL#: 93.224 and 93.527; Program: Health Center Cluster Condition: As a result of our audit procedures, we found four errors in the application of the sliding fee scale. Criteria: The sliding fee scale discount is based on patient income and demographic information. Controls should be in place to ensure the sliding fee scale is consistently applied for each patient. Effect: Continued non-compliance could result in a loss of funding. Additionally, it could result in inequitable access to healthcare services for patients and expose the Center to reputational risks. Context: During our testing, we found 4 of the 40 patients tested were not billed for the proper slide category based on the 2022 sliding fee scale provided by the Center. No questioned costs were identified. Cause: Inadequate internal controls, lack of proper staff training, and insufficient oversight in the application of the sliding fee scale. Recommendation: We recommend that the Center strengthen their internal controls by regularly monitoring patient eligibility and reviewing claims without insurance prior to mailing bills to ensure proper application of the sliding fee scale. Management Response: See Corrective Action Plan.

Categories

Internal Control / Segregation of Duties Subrecipient Monitoring Eligibility

Other Findings in this Audit

  • 25953 2022-001
    Significant Deficiency
  • 25954 2022-002
    Significant Deficiency
  • 25955 2022-001
    Significant Deficiency
  • 602395 2022-001
    Significant Deficiency
  • 602396 2022-002
    Significant Deficiency
  • 602397 2022-001
    Significant Deficiency
  • 602398 2022-002
    Significant Deficiency

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) $2.70M
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $1.81M
93.788 Opioid Str $83,935