Finding 42529 (2022-001)

2022-001 Sliding Fee Discount Determination ALN: 93.224 Program: Health Center Program Cluster Agency: US Department of Health and Human Services Compliance Requirement: N- Special Tests and Provisions Repeat Finding: No Criteria: Federal grant compliance provisions require that the Center correctly identify a patient's ability to pay and that the rates for services be adjusted accordingly based on the sliding fee schedule. The Center is required to follow its sliding fee policy when providing discounts to eligible patients. Finding/ Condition: In the sample of 40 tested items, patient information was inadequate to determine the proper sliding fee discount or the patient was given an innapropriate discount based on information provided. Questioned Cost: None. Effect: Lack of strict enforcement of the policy of sliding fee eligibility determination and compliance may have resulted in the Center providing incorrect discounts for services provided. Cause: There was inadequate understanding and inconsistent handling of the documentation requirements of the sliding fee discount program policies and procedures by certain employees who were involved in sliding fee discount determination. Recommendation: Training should be provided to employees on the sliding fee program requirements. The Center should perform regular audits of sliding fee transactions to identify weaknesses in compliance. Views of Responsible Officials and Corrective Action Plan: The Center agrees with the finding and will implement additional controls to ensure that this does not recur. Please refer to the corrective action plan on page 34.