Finding 49825 (2022-003)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-01-08

AI Summary

  • Core Issue: BPHCC incorrectly applied the sliding fee scale discounts for 3 out of 40 patients due to selecting the wrong class based on income and family size.
  • Impacted Requirements: The sliding fee scale must be accurately applied according to verified income and household size to ensure compliance with audit standards.
  • Recommended Follow-Up: BPHCC should review and improve procedures to ensure proper application and posting of sliding fee discounts for eligible patients.

Finding Text

2022-003 Sliding Fee Scale Criteria ? BPHCC should apply the sliding fee scale based on patient income and family size for qualifying individuals. Condition ? Based on the 40 patients selected for Single Audit compliance testing, we noted 3 errors. In each instance, we noted that the wrong class was selected when applying the sliding fee discount to patient balances based on the patient?s individual incomes and family size of their respective households, resulting in the wrong discount being applied. Cause ? The cause of this deficiency was an error in the application of the effective sliding fee discount schedule based on the verified income and household size of each respective patient. Effect ? The effect was an improper sliding fee discount being applied to various patient accounts based on the effective sliding fee discount schedule and policy. Recommendation ? We recommend that BPHCC review procedures to ensure that sliding fee discounts are properly applied and posted to patient accounts for eligible encounters. Management?s Response ? We recognize the needs for proper internal control processes and procedures to ensure that sliding fee discounts are properly applied and posted to patient accounts for eligible encounters.

Corrective Action Plan

Condition: Sliding fee scale: There were several instances noted where the incorrect sliding fee discount was given to patients based on their verified incomes and household sizes. Action: Management will implement internal control procedures by December 31, 2022, to ensure that sliding fee discounts are properly applied and posted to patient accounts for eligible encounters.

Categories

Internal Control / Segregation of Duties

Other Findings in this Audit

  • 626267 2022-003
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $3.11M
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $702,055