Finding 409735 (2022-001)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-07-04
Audit: 311938
Organization: The Healthcare Connection INC (OH)

AI Summary

  • Core Issue: A patient received a $210 sliding fee discount without proper documentation, violating federal requirements.
  • Impacted Requirements: Health centers must maintain a sliding fee discount schedule based on patients' ability to pay, supported by applications.
  • Recommended Follow-Up: Educate staff on documentation importance and establish a monitoring policy for sliding fee applications.

Finding Text

Finding 2022-001Federal program and specific federal awardU.S. Department of Health and Human Services (HHS)93.224/93.527 Consolidated Health Centers (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, Public Housing Primary Care, and School Based Health Centers); (HHS Community Health Center Program)Specific requirementHealth 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.ConditionDuring a sample of 25 patient visit encounters, we noted that 1 patient visit from March 2022 did not have the applicable sliding fee application on file and the patient charge was adjusted down to zero.CauseThis was due to an error made by manual entry to adjust the sliding fee without sufficient support on file of the patient?s sliding fee application.Effect or potential effectA patient received a sliding fee to write off the entire charge of $210 that was not supported by a sliding fee application. Subsequent to the discovery of the error during the audit, in April 2023, the Organization was able to obtain an application from the patient to support a sliding fee to a charge of $70.Questioned costsNoneRepeat findingNoRecommendationWe recommend that management continue to work and educate front desk and intake staff on the importance of the required patient application documentation so that the required support is obtained before applying a sliding fee discount to a patient account. In addition, we suggest that management establish a policy to perform regular monitoring of a sample of patient file sliding fee applications, to ensure the sliding fee is applied correctly.Management responseWe agreed with the above comment and will implement a system of monitoring sliding fee applications and continue to educate the front desk and intake staff to ensure all documentation is obtained

Categories

Subrecipient Monitoring HUD Housing Programs

Other Findings in this Audit

  • 409733 2022-001
    Significant Deficiency
  • 409734 2022-001
    Significant Deficiency
  • 409736 2022-001
    Significant Deficiency
  • 409737 2022-001
    Significant Deficiency
  • 409738 2022-001
    Significant Deficiency
  • 986175 2022-001
    Significant Deficiency
  • 986176 2022-001
    Significant Deficiency
  • 986177 2022-001
    Significant Deficiency
  • 986178 2022-001
    Significant Deficiency
  • 986179 2022-001
    Significant Deficiency
  • 986180 2022-001
    Significant Deficiency

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) $1.58M
93.498 Provider Relief Fund $790,085
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $237,624
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $211,074
93.461 Covid-19 Testing for the Uninsured $183,003