Finding Text
Criteria - Health centers must prepare and apply a sliding fee discount schedule ("SFDS") so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay, as outlined in 42 CFR sections 51c.303(e), (f), and (g) and 42 CFR sections 56.303(e), (f), and (g). Condition - The Committee charged at least one eligible patient an incorrect amount in accordance with the SFDS. Cause - The Committee's employees who are responsible for applying the sliding fee discount are not properly trained. Additionally, the Committee experienced turnover in the accounting department and did not follow established internal controls pertaining to the sliding fee discount review and approval process. Effect - Eligible patient(s) were overcharged for health services provided by the Committee based on the SFDS. Questioned Costs - None. Context - There was at least one eligible patient who, based on their annual income and family size, should have had a specified discount applied to their health service charges as outlined on the SFDS. However, an incorrect slide level discount was applied to their account by the Committee?s staff, and therefore, certain patient(s) were overcharged for the services provided by the Committee. Identification as a Repeat Finding - This is a repeat finding. Recommendation - Implement proper training for all health center staff who have the responsibility of applying the sliding fee discounts and charging patients. Additionally, establish and maintain proper controls so that sliding fee discounts applied to eligible patient accounts are properly approved by an appropriate level of the Committee's management. The Committee?s Response - See corrective action plan.