Finding Text
Information on the federal program - Assistance Listing Number 93.224, Health Center Program Cluster from the U.S. Department of Health and Human Services,
Federal Award No. 6 H80CS07897 for project period February 1, 2020 through January 31, 2024.
Criteria or specific requirement - Health centers must prepare and apply a sliding fee discount schedule that incorporates the provisions of 42 CFR 51c.3032 through 56.303g to ensure that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay.
Condition - The audit of the major federal program identified errors in the application of sliding fee adjustments.
Questioned costs - Not applicable
Context - Out of a population of 11,125 sliding fee adjustments, a sample of 25 adjustments were tested. Out of the 25 tested, 3 adjustments were incorrectly calculated based on the Organization’s approved sliding fee scales and the patient’s
sliding fee application. A non-statistical sampling methodology was used to select the sample.
Effect - The sliding fee adjustments were not appropriately applied.
Cause - Manual inputs required to calculate the sliding fee discounts resulted in errors in application of the sliding fee scales.
Identification as a repeat finding - Not a repeat finding.
Recommendation - We recommend that the Organization implement a review process for sliding fee and other adjustments applied in the billing system, including review for the sliding fee application and relating supporting documents. Additionally, we
recommend that a member of management with an understanding of the Organization’s billing and sliding fee policies regularly review a sample of sliding fee adjustments in comparison to the Organization’s sliding fee policy.
Views of responsible officials and planned corrective actions - The Organization agrees with the finding. See separate auditee document for planned corrective action.