Finding 45552 (2022-001)

#2022-001 Sliding Fee Discounts Documentation U.S. Department of Health and Human Services Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care)- AL #93.224 Grants for New and Expanded Services Under the Health Center Program - AL #93.527 Condition: The Center lacked documentation on sliding fee discount eligibility for 1 (one) patient under the Center's policy. Criteria: Special Tests and Provisions: Sliding Fee Discounts - 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. Cause: The condition is attributable to the lack of internal controls to ensure that the proper sliding fee documentation is being collected and retained to support the determination of adjustments to patient charges. Effect: The Center did not always follow policies and procedures and may not have properly calculated the sliding fee discount given to the patients, and the discount given may not have been based on the patient's ability to pay. Context: A sample of 40 patient encounters were tested out of the population of 207 sliding fee discount transactions. Of the 40 patient encounters tested, it was determined that the Center lacked documentation on sliding fee eligibility to support 1 (one) patient encounter tested. Recommendation: We recommend the Center provide training to employees to ensure that the sliding fee discounts are being properly applied, supported and documented. In addition, we recommend the employees administering the sliding fee discounts be properly monitored and supervised to ensure compliance with program documentation. Views of Responsible Officials and Planned Corrective Action: The Mountaineer Community Health Center, Inc. 's management will take the necessary steps to ensure that the sliding fee discounts are being properly applied and documented to support the determination of adjustments to patient charges. Identification of Repeat Finding: The finding was reported in the prior year's audit as finding #2021-001. Total Questioned Costs $ -0-