Finding Text
Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Centers Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00276-20; H80CS00276-21 Award Periods: June 1, 2021 ? May 31, 2022; June 1, 2022 ? May 31, 2023 Type of Finding: Compliance and significant deficiency in internal control over compliance Criteria: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The Organization had assessed four patients with the incorrect sliding fee discount; three patients were assessed a higher discount and one patient was assessed a lower discount based on their family size and income information that was documented. Questioned Costs: None. Context: Four (4) of forty (40) transaction tested. Cause: Patients? family size and income information was either not received or was not reviewed and updated within the Center?s billing system. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Views of Responsible Officials: There is no disagreement with the audit finding.