Finding 484794 (2023-001)

-
Requirement
N
Questioned Costs
-
Year
2023
Accepted
2024-08-22

AI Summary

  • Core Issue: Incorrect sliding fee scale calculations led to three patients being overcharged.
  • Impacted Requirements: The organization must adhere to its established sliding fee scale policy for patient discounts.
  • Recommended Follow-Up: Provide training for staff on eligibility calculations and ensure proper use of the new billing software.

Finding Text

Finding – Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) (ALN 93.224) and Grants for New and Expanded Services under the Health Center Program (ALN 93.527) Criteria: Family Health Network of Central New York, Inc. is required to have a sliding fee scale policy and to provide discounts to patients based on the established policy. Condition: During our audit, we tested a sample of 25 sliding fee scale calculations. Three patients in our sample were charged the incorrect amount based on the sliding fee determination. The sliding fee scale calculation used the incorrect slide discount percentage. Context: We reviewed 25 patient’s files for documentation of sliding fee scale calculations. Cause: Inconsistent application of sliding fee scale calculations with change in billing software during the year. Effect: Family Health Network of Central New York, Inc. is not following its established policy. Recommendation: We recommend that Family Health Network of Central New York, Inc. provide training to those making eligibility calculations and implementation in the new billing software.

Corrective Action Plan

Recommendation: Our auditors recommended that we provide training to those making eligibility calculations and implementation in the new billing software. Action Taken: We are currently in the process of retraining staff on the sliding fee scale procedures and implementation in the new billing software. Name of Contact Person Responsible for Corrective Action: Kimberly Osborne, President/Chief Executive Officer, (607) 753-3797. Anticipated Completion Date: June 2024

Categories

Eligibility HUD Housing Programs

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $2.39M
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $661,973
93.994 Maternal and Child Health Services Block Grant to the States $26,534