Finding Text
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 42 CFR section 51c 303(f), health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay.
Condition Not all patients had valid sliding fee applications on file and not all patients received accurate sliding fee adjustments.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During special test/sliding fee testing, noted 16 patients out of a sample of 60 did not have a valid sliding fee application on file. Of the remaining 44 patients, 17 had an incorrect sliding fee adjustment applied based on family income and size.
Cause and Effect An appropriate review of sliding fee applications and adjustments was not completed to ensure valid applications were maintained and the correct adjustment was applied. As a result, not all patients received the correct adjustment and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including levels of review, to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.