Finding 48369 (2022-001)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-05-02

AI Summary

  • Core Issue: A patient was overcharged due to an incorrect sliding fee discount applied, violating compliance requirements.
  • Impacted Requirements: Health centers must use an updated sliding fee discount schedule to adjust charges based on patients' ability to pay.
  • Recommended Follow-Up: Implement a process to regularly evaluate patient applications to ensure the correct sliding fee discount is applied.

Finding Text

Finding 2022-001: Program Name/ALN Title: Health Center Cluster Federal Assistance Listing Number: 93.224/93.527 Federal Agency: U.S Department of Health and Human Services Award Period: 1/1/2022 ? 12/31/2022 Federal Award Number: N/A Type of Finding: Significant Deficiency Criteria: Under the compliance requirement for Special Tests and Provisions for ALN 93.224/93.527, ?health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health c enter services by eligible patients are adjusted (discounted) based on the patients ability to pay?. In on identified instance, an incorrect sliding fee discount was applied, resulting in the patient being overcharged for services provided. Condition: CLA identified one instance of the key control not being met while performing testing over the special tests and provisions compliance requirements. Context: CLA identified one instance out of forty total tested of which the key control was not being met while performing testing over the special tests and provisions compliance requirement. Cause: The sliding fee application effective for the transaction tested indicated the patient qualified for a Level 1 sliding fee discount, however, the system was not updated for this change and the patient?s charges were applied to the previous Level 3 sliding fee discount on file for the patient. Effect: Incorrect sliding fee discount was applied to the transaction tested resulting in the patient being overcharged for services. Recommendation: We recommend that CBHA implement a process for evaluating each patient application contract to ensure the most up to date patient application is being used to determine the appropriate slide amount to be applied. Views of the Responsible Officials: There is no disagreement with the audit finding.

Corrective Action Plan

Corrective Action Plan: CBHA updated its process to assign current year cases to patients under the sliding fee program. Previous cases are now closed at the end of the benefit year preventing staff from selecting an incorrect case under the sliding fee program. This alerts staff that the patient's coverage is expiring and needs to be renewed. In addition, an electronic audit is performed on all sliding fee appointments that identifies any discrepancy between the active billing profile and the sliding fee profile applied to a visit.

Categories

Special Tests & Provisions Significant Deficiency

Other Findings in this Audit

  • 48370 2022-001
    Significant Deficiency
  • 624811 2022-001
    Significant Deficiency
  • 624812 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 $5.48M
93.224 Covid-19 American Rescue Plan Act for Health Centers $3.74M
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.91M
93.498 Covid-19 Provider Relief Funds $742,239
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $660,049
93.224 Covid-19 Fy 2020 Expanding Capacity for Coronavirus Testing (ect) $417,334
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $303,574
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $143,302
93.461 Covid-19 Testing for the Uninsured $120,622
84.181 Special Education-Grants for Infants and Families $97,084
93.217 Family Planning_services $41,884