Finding 45837 (2022-001)

Finding 2022-001 ? Material Weakness and Nonmaterial Noncompliance in Internal Control over Retention of Supporting Documentation Relating to Sliding Fee Test. Condition: During the audit, 40 sliding fee payments were selected for testing; however, insufficient supporting evidence was provided for six sample items which did not substantiate patient household income and number of residents who resided within the household. Criteria: The Organization is responsible for charging a sliding fee based on household income and number of residents that reside within the patient?s household. Cause: The Organization did not have fully operating controls in place to ensure required documentation was received and/or maintained for some patients who received services. Effect: The audit team was unable to verify or validate that participants were appropriately charged due to the inability to review sufficient supporting documentation. Therefore, the audit team is unable to conclude that the Organization is compliant with the requirement to charge patients the appropriate sliding fee. Recommendation: We recommend controls and procedures be implemented to ensure all supporting documentation substantiating all patient household income and the number of residents who reside within their household is obtained and verified before services are provided. It should then be retained as supporting documentation that this compliance test has been completed and validated. Management?s Response: Management agrees with the finding and is in the process of developing and implementing a comprehensive plan to ensure that appropriate documentation regarding household income and number of residents who reside within the individual?s household is obtained and retained prior to any services being provided to a patient.