Finding 524761 (2024-004)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2024
Accepted
2025-02-27
Audit: 344160
Auditor: Marcum LLP

AI Summary

  • Core Issue: There are significant errors in applying the sliding fee discount schedule (SFDS), affecting compliance with federal requirements.
  • Impacted Requirements: Health centers must accurately calculate and apply SFDS based on patients' ability to pay, as mandated by federal regulations.
  • Recommended Follow-Up: Review and improve SFDS processes, and retrain staff to ensure accurate and consistent application of discounts.

Finding Text

FINDING 2024-004 Special Tests and Provisions – Application of Sliding Fees FINDING TYPE Significant Deficiency in Internal Control over Compliance AGENCY U.S. Department of Health and Human Services ALN 93.224 / 93.527 Health Center Cluster CRITERIA In accordance with 42 USC 254b(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g) 2 CFR 200.302 (b)(3), health centers must prepare and apply a sliding fee discount schedule (SFDS) so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. CONDITION AND CONTEXT During the year ended June 30, 2024, out of a sample of 40 transactions, we noted 12 instances where the sliding fee discount was either incorrectly calculated or not applied. In addition, we noted 4 items for which documentation supporting the fee was not available. The known error in the sample was $725 and the projected total error was $4,169. CAUSE Given the volume of patients served by the health center program, there were instances where the staff made errors in the application of the SFDS. EFFECT OR POTENTIAL EFFECT The organization was not consistently in compliance with the SFDS requirements of the health center program. REPEAT FINDING No. RECOMMENDATION We recommend that the organization implement a review of its SFDS protocols and adjust processes and retrain staff to ensure consistent application of the SFDS. VIEWS OF RESPONSIBLE OFFICIALS AND PLANNED CORRECTIVE ACTION See attached corrective action plan. Questioned Costs None.

Corrective Action Plan

Management will review the SFDS protocols and processes with the appropriate staff in order enable the consistent application of sliding fees. This will be completed by June 30, 2025.

Categories

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

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
16.034 Coronavirus Emergency Supplemental Funding Program $1.11M
93.150 Projects for Assistance in Transition From Homelessness (path) $272,728
93.217 Family Planning Services $246,704
93.224 Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $198,791
14.239 Home Investment Partnerships Program $195,855
93.788 Opioid Str $110,302
93.959 Block Grants for Prevention and Treatment of Substance Abuse $105,560
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $100,414
93.778 Medical Assistance Program $83,859
93.958 Block Grants for Community Mental Health Services $78,989
93.493 Congressional Directives $78,684
93.526 Grants for Capital Development in Health Centers $68,623
14.218 Community Development Block Grants/entitlement Grants $67,549
21.027 Coronavirus State and Local Fiscal Recovery Funds $64,618
97.024 Emergency Food and Shelter National Board Program $53,249
14.231 Emergency Solutions Grant Program $48,540
14.267 Continuum of Care Program $32,440
93.994 Maternal and Child Health Services Block Grant to the States $32,088
93.527 Grants for New and Expanded Services Under the Health Center Program $24,926
93.667 Social Services Block Grant $21,678
93.569 Community Services Block Grant $15,812
93.914 Hiv Emergency Relief Project Grants $15,597
16.745 Criminal and Juvenile Justice and Mental Health Collaboration Program $5,341