Finding 513624 (2023-101)

Material Weakness
Requirement
ABCHILN
Questioned Costs
-
Year
2023
Accepted
2024-12-09
Audit: 331540
Organization: Circle the City (AZ)

AI Summary

  • Core Issue: Missing patient attestation forms hinder accurate discount calculations for sliding fee scale (SFS) discounts.
  • Impacted Requirements: Compliance with 42 CFR Section 51c.303(f) regarding proper documentation of income levels for SFS discounts.
  • Recommended Follow-Up: Implement random reviews of SFS applications to identify and correct errors or incomplete submissions promptly.

Finding Text

Special Tests and Provisions - Sliding Fee Scale Discounts Federal program: FAL 93.224 Health Center Program U.S. Department of Health and Human Services Federal grant number: H8HCS44987 Criteria: Patients applying for sliding fee scale (SFS) discounts should have their income levels adequately documented and accurately calculated, and patients should be given the proper discount based upon their income level in accordance with 42 CFR Section 51c.303(f). Condition: The Organization requires patients that apply for the SFS discount to complete attestation forms that includes their household sizes and income levels, and these forms are then used to determine patients' SFS discounts. One patient attestation form out of twenty-five SFS patient encounters that we tested was missing, and another SFS encounter that we tested did not have patient attestation form covering the date of service. Cause: Unknown Effect: Due to missing attestation forms, we could not determine whether the Organization consistently provided patients with the proper discount based upon their income levels. Recommendation: To help ensure that SFS discounts are properly calculated and documented, the Organization should perform random reviews of its SFS applications in order to detect and correct errors or incomplete applications on a timely basis.

Corrective Action Plan

Recommendation: To help ensure that SFS discounts are properly calculated and documented, the Organization should perform random reviews of its SFS applications in order to detect and correct errors or incomplete applications on a timely basis. Action Taken: CTC has designated a person in the Finance Department to audit Income Attestations. Rather than just do random reviews, all patients requiring an Income Attestation are audited every month. This process occurred for most of 2023 and all of 2024. In addition, one of CTC's key performance indicators (KPls) is the expectation that 100% of all patients will have an income attestation. For all of FY24 and now FY25 year-to-date, this KPI metric was and will continue to be measured and reported to CTC leadership every month to ensure full compliance. Contact Person: John Moore, CFO Anticipated Completion Date: Completed

Categories

Special Tests & Provisions

Other Findings in this Audit

  • 513625 2023-101
    Material Weakness
  • 513626 2023-102
    Material Weakness
  • 513627 2023-102
    Material Weakness
  • 513628 2023-102
    Material Weakness
  • 513629 2023-102
    Material Weakness
  • 1090066 2023-101
    Material Weakness
  • 1090067 2023-101
    Material Weakness
  • 1090068 2023-102
    Material Weakness
  • 1090069 2023-102
    Material Weakness
  • 1090070 2023-102
    Material Weakness
  • 1090071 2023-102
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.224 Community Health Centers $591,730
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $249,410
93.526 Fip Verification $75,514