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.