Finding 31564 (2022-002)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-09-28
Audit: 31462
Auditor: Forvis LLP

AI Summary

  • Core Issue: Patients received sliding fee discounts that did not match the organization's policy or comply with federal guidelines.
  • Impacted Requirements: The organization’s sliding fee policy was inconsistent with both its own guidelines and the Health Center Program Compliance Manual.
  • Recommended Follow-Up: Update the sliding fee policy to ensure compliance and provide training to staff on the correct application of the policy.

Finding Text

Health Center Program Cluster Assistance Listing Numbers 93.224 and 93.527 U.S. Department of Health and Human Services Criteria or Specific Requirement ? Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR sections 51c.303(g); and 42 CFR sections 56.303 (f)) Condition ? Patients received a sliding fee discount that was inconsistent with the stated sliding fee discount categories under the Organization?s policy or not compliant with the Health Center Program Compliance Manual. Questioned cost ? None Context ? A sample of 25 patients were tested out of the total population of 68,391 encounters. The sampling methodology used is not and is not intended to be statistically valid. Three patients received a sliding fee adjustment that was inconsistent with the approved policy for the proper sliding fee adjustment based on their income documentation. One patient received a sliding fee adjustment that is inconsistent to the Health Center Program Compliance Manual as the Organization?s policy was not in compliance with the Health Center Program Compliance Manual. Effect ? Sliding fee discounts were given to patients that were inconsistent with the Organization?s sliding fee discount policy. Cause ? The Organization did not comply with their sliding fee policy and a portion of the sliding fee policy was not in compliance with the Health Center Program Compliance Manual. Identification as a repeat finding, if applicable ? Is not a repeat finding. Recommendation ? We recommend management update their sliding fee policy to be in compliance with the Health Center Program Compliance Manual. Additionally, the Organization should continue to ensure all personnel understand the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy.

Categories

Special Tests & Provisions

Other Findings in this Audit

  • 31563 2022-002
    Significant Deficiency
  • 31565 2022-002
    Significant Deficiency
  • 608005 2022-002
    Significant Deficiency
  • 608006 2022-002
    Significant Deficiency
  • 608007 2022-002
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $4.81M
93.224 Covid-19 - Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.89M
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.48M
93.918 Ryan White Capacity Grant $853,300
32.006 Covid-19 Telehealth Program $703,990
93.917 Hiv Care Formula Grants $379,113
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $302,965
93.185 Immunization Research, Demonstration, Public Information and Education_training and Clinical Skills Improvement Projects $101,372
93.493 Congressional Directives $79,688
93.526 Covid-19 - Affordable Care Act (aca) Grants for Capital Development in Health Centers $78,606
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $29,415
93.917 Covid-19 - Hiv Care Formula Grants $18,080
94.016 Senior Companion Program $7,106