Finding Text
2022-003 – Special Tests and Provisions
Federal agency: U.S. Department of Health and Human Services
Federal program title: Health Centers Cluster
Assistance Listing Number: 93.224/93.527
Pass-Through Agency: n/a
Pass-Through Number(s): n/a
Award Period: 6/1/21-5/31/22 & 6/1/22-5/31/23
Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matters
Criteria or specific requirement: 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 assessed an incorrect sliding fee discount.
Questioned costs: None.
Context: The Organization assessed one of forty patient encounters selected for testing, the incorrect
sliding fee discount.
Cause: Unknown
Effect: Patients are not charged according to the Organization's sliding fee scale and their ability to
pay.
Repeat Finding: The finding is a repeat of a finding in the immediately prior year. Prior year finding
number was 2021-008.
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.