Finding 367033 (2023-001)

Material Weakness
Requirement
N
Questioned Costs
-
Year
2023
Accepted
2024-02-13

AI Summary

  • Core Issue: There was a material weakness in internal controls, leading to incorrect application of the sliding fee scale for 7 out of 40 payments tested.
  • Impacted Requirements: The Organization failed to properly charge fees based on accurate household income and resident counts, affecting 8 patients.
  • Recommended Follow-Up: Implement a secondary review process for sliding scale applications before billing to ensure accuracy and compliance.

Finding Text

Finding 2023-001 – Material Weakness and Nonmaterial Noncompliance in Internal Control over Retention of Supporting Documentation Relating to Sliding Fee Test. Condition: During the audit, 40 sliding fee payments were selected for testing; however, the sliding scale was applied incorrectly for 7 sample items based on reported patient household income and number of residents who resided within the household. Criteria: The Organization is responsible for charging a sliding fee based on household income and number of residents that reside within the patient’s household. Cause: The Organization did not have fully operating controls in place to ensure the sliding scale was applied correctly for patients who received services. Effect: Eight patients were charged incorrectly based on patient household income and number of residents who resided within the household. Recommendation: We recommend controls and procedures be implemented to ensure the sliding scale application and assessed rate is reviewed by a secondary reviewer prior to billing. Management’s Response: Management agrees with the finding and is in the process of developing and implementing a comprehensive plan to ensure appropriate documentation regarding household income and number of residents who reside within the individual’s household is obtained and retained prior to any services being provided to a patient.

Corrective Action Plan

Federal Award Findings and Questioned Costs - Major Federal Awards Finding 2023-001 Material Weakness and Nonmaterial Noncompliance in Internal Control over application of sliding fee test. 2023-001 Recommendation: The Organization should ensure that controls and procedures are implemented to ensure the sliding fee application and assessed rate is reviewed by a secondary reviewer prior to billing. Action Taken: We concur with the recommendation and will establish procedures to ensure supporting documentation substantiating all patient household income and the number of residents who reside within their household is obtained and verified before services are provided. This process will indude the following: • Additional training for appropriate staff • Individual assessment of staff accuracy for training purposes • Reassignment of SFDS application audit function • Quarterly reporting to the Board of Directors on SFDS activities Date of Completion: April 30,2024 If the U.S. Department of Health and Human Services has questions regarding this plan, please call Valerie Butt, Chief Financial Officer, at 757-618-0476. Sincerely, Valerie Butt Chief Financial Officer.

Categories

Material Weakness Internal Control / Segregation of Duties

Other Findings in this Audit

  • 367034 2023-001
    Material Weakness
  • 367035 2023-001
    Material Weakness
  • 367036 2023-001
    Material Weakness
  • 367037 2023-001
    Material Weakness
  • 367038 2023-001
    Material Weakness
  • 943475 2023-001
    Material Weakness
  • 943476 2023-001
    Material Weakness
  • 943477 2023-001
    Material Weakness
  • 943478 2023-001
    Material Weakness
  • 943479 2023-001
    Material Weakness
  • 943480 2023-001
    Material Weakness

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) $820,044
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $67,470