Finding 49840 (2022-001)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-08-30
Audit: 42500
Organization: La Pine Community Health Center (OR)

AI Summary

  • Core Issue: La Pine Community Health Center inaccurately applied sliding fee discounts to uninsured patients, leading to improper discounts.
  • Impacted Requirements: The sliding fee discounts must align with the Organization's policy and Federal Poverty Guidelines.
  • Recommended Follow-Up: Conduct regular internal audits and provide training to staff to ensure correct application of sliding fee discounts.

Finding Text

2022-001 Sliding Fee Program Discount Federal agency: U.S. Department of Health and Human Services Federal program title: Health Center Program Cluster CFDA Number: 93.224 and 93.527 Award Period: March 1, 2021 ? February 28, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance Condition: La Pine Community Health Center?s (the Organization) sliding fee discount program provides discount to uninsured patients based on the patient?s income and poverty levels. During our audit we noted two instances of an inaccurate sliding fee discount provided. Criteria or specific requirement: Per the Organization?s sliding fee policy, sliding fee discounts are determined and applied based on the patient's financial class per the Federal Poverty Guidelines. Special Tests and provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR section 51c.303(g) and 42 CFR section 56.303(f)). Questioned costs: None. Context: An initial sample of 25 encounters were tested in relation to the sliding fee discount program. Of the 25 encounters tested, there was one where the patient was assigned an incorrect sliding fee level based on their income and family size. Cause: Incorrect application of sliding fee determination. Effect: Improper sliding fee discounts were given to patients. Recommendation: CLA recommends that the Organization periodically perform internal audit procedures to identify and correct instances of misapplied sliding fee discounts. View of responsible officials and planned corrective actions: There is no disagreement with the audit finding. A review of internal procedures will be conducted to ensure that the internal control over the sliding fee program is operating. Additionally, training, and internal audits will be conducted with the responsible staff as appropriate.

Corrective Action Plan

U.S. Department of Health and Human Services La Pine Community Health Center respectfully submits the following corrective action plan for the year ended October 31, 2022. Audit period: November 1, 2021 ? October 31, 2022 The findings from the schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the numbers assigned in the schedule. FINDINGS?FEDERAL AWARD PROGRAM AUDIT Significant Deficiency 2022-001 Health Center Program Cluster ? CFDA No. 93.224 and 93.527 Condition: La Pine Community Health Center?s sliding fee discount program provides discounts to uninsured and insured patients based on the patient?s income and poverty levels. During our audit we noted one instance of an inaccurate sliding fee discount provided. Criteria or specific requirement: Per La Pine?s Community Health Center?s sliding fee policy, sliding fee discounts are determined and applied based on the patient's financial class per the Federal Poverty Guidelines. Special Tests and provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR section 51c.303(g) and 42 CFR section 56.303(f)). Recommendation: CLA recommends that La Pine Community Health Center periodically perform internal audit procedures to identify and correct instances of misapplied sliding fee discounts. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: A review of internal procedures will be conducted to ensure that the internal control over the sliding fee program is operating. Additionally, training and internal audits will be conducted with the responsible staff as appropriate. Name(s) of the contact person(s) responsible for corrective action: Karen Forman, Controller. Planned completion date for corrective action plan: October 31, 2023

Categories

Special Tests & Provisions Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 49841 2022-001
    Significant Deficiency
  • 626282 2022-001
    Significant Deficiency
  • 626283 2022-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
10.766 Community Facilities Loans and Grants $5.39M
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $1.23M
93.224 Covid-19 American Rescue Plan Act Funding for Health Centers $977,250
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $325,536
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $142,189
93.461 Covid-19 Testing for the Uninsured $926