Finding 396628 (2023-002)

Significant Deficiency Repeat Finding
Requirement
N
Questioned Costs
$1
Year
2023
Accepted
2024-05-14
Audit: 306236
Organization: Midmichigan Health Services (MI)

AI Summary

  • Core Issue: Significant deficiency in applying the sliding fee discount schedule (SFDS) led to incorrect adjustments for some patients.
  • Impacted Requirements: Compliance with 42 CFR section 51c 303(f) regarding proper fee adjustments based on patients' ability to pay.
  • Recommended Follow-Up: Implement review controls to ensure all sliding fee adjustments use the correct and updated SFDS.

Finding Text

Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; Health Center Program Cluster (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) Federal Award Identification Number and Year H8GCS47788, H8LCSS0692, H8OCS000190, H8FCS41189, and C8ECS43772 2023 Pass through Entity N/A Finding Type Significant deficiency and material noncompliance with laws and regulations Repeat Finding Yes 2022 001 Criteria In accordance 42 CFR section 51c 303(f), 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. Condition Not all patients received updated adjustments based on the new schedule. Questioned Costs Unknown Identification of How Questioned Costs Were Computed N/A Context Out of a sample of 40 patients tested, the sliding fee adjustment for 3 patients was incorrect. The Company improperly applied discount using an outdated sliding fee discount schedule (SFDS). Cause and Effect An appropriate review of sliding fee adjustments was not completed to ensure the correct adjustment was applied. As a result, not all patients received updated adjustments based on the new schedule. Recommendation We recommend the Company implement controls, including levels of review, to ensure sliding fee adjustments are based on correct SFDS. Views of Responsible Officials and Planned Corrective Actions The Company will review sliding fee adjustments to ensure they are based on the correct, most up to date sliding fee discount schedule.

Categories

Questioned Costs HUD Housing Programs Significant Deficiency

Other Findings in this Audit

  • 396622 2023-001
    Significant Deficiency
  • 396623 2023-001
    Significant Deficiency
  • 396624 2023-001
    Significant Deficiency
  • 396625 2023-001
    Significant Deficiency
  • 396626 2023-001
    Significant Deficiency
  • 396627 2023-002
    Significant Deficiency Repeat
  • 396629 2023-002
    Significant Deficiency Repeat
  • 396630 2023-002
    Significant Deficiency Repeat
  • 396631 2023-002
    Significant Deficiency Repeat
  • 973064 2023-001
    Significant Deficiency
  • 973065 2023-001
    Significant Deficiency
  • 973066 2023-001
    Significant Deficiency
  • 973067 2023-001
    Significant Deficiency
  • 973068 2023-001
    Significant Deficiency
  • 973069 2023-002
    Significant Deficiency Repeat
  • 973070 2023-002
    Significant Deficiency Repeat
  • 973071 2023-002
    Significant Deficiency Repeat
  • 973072 2023-002
    Significant Deficiency Repeat
  • 973073 2023-002
    Significant Deficiency Repeat

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) $2.94M
93.224 Covid-19 - Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $466,951
93.527 Covid-19 - Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $114,897
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $10,400