FAC Explorer

Finding 526626 (2024-002)

Significant Deficiency
Requirement
N
Questioned Costs
$1
Year
2024
Accepted
2025-03-11
Audit: 345566
Organization: Brevard Health Alliance, Inc. (FL)
Auditor: Carr Riggs & Ingram LLC

AI Summary

  • Core Issue: One patient out of 25 was charged incorrectly due to a manual error in applying the sliding fee scale.
  • Impacted Requirements: Compliance with 42 CFR sections 51c.303 (f) and 2 CFR 200.303 regarding fee schedules and internal controls.
  • Recommended Follow-Up: Implement procedures to verify the sliding fee schedule for new patients to prevent future errors.

Finding Text

2024 – 002 – Special Test and Provisions Health Center Program & Grants for New and Expanded Services under the Health Center Program Assistance Listing Number: 93.224 & 93.527 Federal Award ID Number: H8004213 H8F41284 C1650401 H8G47667 H8L51683 H2E45573 Department of Health and Human Services Funding 2024 Criteria: 42 CFR sections 51c.303 (f) requires that Brevard Health Alliance “have prepared a schedule of fees or payments for the provision of its services designed to cover its reasonable costs of operation and a corresponding schedule of discounts adjusted on the basis of the patient's ability to pay.” The schedule of discounts must provide for a full discount to individuals and families with annual incomes at or below those set forth in the poverty guidelines updated periodically in the Federal Register by the U.S. Department of Health and Human Services under the authority of 42 U.S.C 9902(2); and for no discount to individuals and families with annual incomes greater than twice those set forth in such guidelines. 2 CFR 200.303 provides that non-Federal entities must establish and maintain effective internal controls to provide reasonable assurance of compliance with Uniform Guidance. Condition: CRI selected a sample of 25 patients to ensure the sliding fee schedule was properly applied. 1 of the 25 patients had the incorrect fee scale applied. Cause: The cause appears to be human error by an employee selecting the incorrect sliding fee scale. Identifying every manual input error is difficult, however, the Alliance performs an audit of the sliding fee schedule for thousands of patients on an annual basis. Effect: Patients could be paying more or less than what is allowable based on the fee schedule. Questioned Cost: Undeterminable as the grant is not reimbursed based on patient fees. Perspective: The issue appears isolated as it was a 4% failure rate (1 out of 25). Recommendation: Procedures should be implemented to verify the sliding fee schedule applied to new patients.

Corrective Action Plan

SPECIAL TEST AND PROVISIONS CRI selected a sample of 25 patients to ensure the sliding fee schedule was properly applied. 1 of the 25 patient had the incorrect fee scale applied. Recommendation: Procedures should be implemented to verify the sliding fee schedule applied to new patients. Responsible Party: Shannon Wherry, Controller Corrective Action: Management will establish a procedure to ensure the sliding fee schedule is applied to all new patients. Brevard Health Alliance will continue to audit the sliding fee schedule on an annual bases, at minimum, in addition to sampling sliding fee scale patient charts quarterly. Estimated date of ompletion: Management estimates that the above findings will be corrected by the year ended September 30, 2025.

Categories

Questioned Costs Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties Special Tests & Provisions

Other Findings in this Audit

  • 526619 2024-001
    Significant Deficiency
  • 526620 2024-001
    Significant Deficiency
  • 526621 2024-001
    Significant Deficiency
  • 526622 2024-001
    Significant Deficiency
  • 526623 2024-001
    Significant Deficiency
  • 526624 2024-001
    Significant Deficiency
  • 526625 2024-001
    Significant Deficiency
  • 526627 2024-002
    Significant Deficiency
  • 526628 2024-002
    Significant Deficiency
  • 526629 2024-002
    Significant Deficiency
  • 526630 2024-002
    Significant Deficiency
  • 526631 2024-002
    Significant Deficiency
  • 526632 2024-002
    Significant Deficiency
  • 1103061 2024-001
    Significant Deficiency
  • 1103062 2024-001
    Significant Deficiency
  • 1103063 2024-001
    Significant Deficiency
  • 1103064 2024-001
    Significant Deficiency
  • 1103065 2024-001
    Significant Deficiency
  • 1103066 2024-001
    Significant Deficiency
  • 1103067 2024-001
    Significant Deficiency
  • 1103068 2024-002
    Significant Deficiency
  • 1103069 2024-002
    Significant Deficiency
  • 1103070 2024-002
    Significant Deficiency
  • 1103071 2024-002
    Significant Deficiency
  • 1103072 2024-002
    Significant Deficiency
  • 1103073 2024-002
    Significant Deficiency
  • 1103074 2024-002
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.526 Grants for Capital Development in Health Centers $233,864
93.527 Grants for New and Expanded Services Under the Health Center Program $190,944
93.244 Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $118,814
93.527 Covid-19 Grants for New and Expanded Services Under the Health Center Program $100,175
93.917 Hiv Care Formula Grants $6,587