Finding Text
Assistance Listing Number, 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 - H8FCS41189, C8ECS43772, and H80CS00190 2022 Pass through Entity - N/A Finding Type - Significant deficiency Repeat Finding - No 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. Condition - The Company has a sliding fee discount policy that is based on income and family size in place. However, management did not follow the Company?s policy for all patients during the period under audit. Questioned Costs - None Identification of How Questioned Costs Were Computed - N/A Context - Out a sample of 25 patients tested, the sliding fee adjustment for 1 patient was posted to a patient account that was not eligible to receive a sliding fee discount. The Company improperly coded this adjustment as a sliding fee discount funded with grant dollars when it should have been coded as a contractual adjustment funded by nonfederal sources. Cause and Effect - An appropriate review of sliding fee adjustments was not completed to ensure they represent adjustments for eligible patients. Recommendation - We recommend the Company implement controls, including levels of review, to ensure sliding fee adjustments are posted to eligible patient accounts only. Views of Responsible Officials and Corrective Action Plan - The Company will review sliding fee adjustments to ensure they are posted only to eligible patient accounts to prevent this issue from recurring.