Finding 42772 (2022-002)

Significant Deficiency Repeat Finding
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-02-16

AI Summary

  • Core Issue: Some patients did not receive the correct sliding fee discounts based on their ability to pay.
  • Impacted Requirements: Health Centers must apply a sliding fee discount schedule accurately for eligible patients.
  • Recommended Follow-Up: Management should implement procedures to ensure all eligible patients receive the correct discounts.

Finding Text

Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted or discounted based on the patient?s ability to pay. Condition: Some patients did not receive the proper sliding fee discount. Cause: Errors within the setup of the Center?s billing software. Context: Of the 60 patients sampled, 17 patients did not receive the proper adjustment or discount. Effect: Improper adjustments or discounts could lead to inaccurate financial statements as well as improper patient billings. Auditor's Recommendation: Management should have procedures in place ensuring that each eligible patient receives the proper discount or adjustment.

Corrective Action Plan

The Center agrees with the finding and understood it would repeat from FY2021 because TCHC would not have time to correct issues that would impact the FY2022 audit. The health center received additional training on-site from the practice management system vendor in May/June 2022; during this training, sliding fee setup in the system was reviewed and training provided to update. In response, as of May 2022, the incomes were updated in the system to correspond to the 2022 poverty guidelines set up and updated in February 2023 for 2023 poverty guidelines. Management is in the process of updating written procedures to reconcile with actual steps occurring, including the responsible person, etc. In addition, an audit procedure will be further refined so periodic surveys can determine if policies and procedures are being followed. The health center continues to have turnover at the front desk staff due to COVID-19 and attrition, which gives rise to the need for training staff on the sliding fee policy and procedure when onboarded as well annually. All these steps will be completed by February 28, 2023.

Categories

No categories assigned yet.

Other Findings in this Audit

  • 42773 2022-001
    Significant Deficiency
  • 619214 2022-002
    Significant Deficiency Repeat
  • 619215 2022-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $1.08M
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $491,355
93.498 Provider Relief Fund $71,799
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $0