Finding 554938 (2024-001)

Significant Deficiency Repeat Finding
Requirement
N
Questioned Costs
-
Year
2024
Accepted
2025-04-14

AI Summary

  • Core Issue: Incorrect income data entry for 2 patients and use of net income instead of gross income for 3 patients led to improper sliding fee discounts.
  • Impacted Requirements: The Sliding Fee Discount Program requires gross income figures, which was not followed in the calculations.
  • Recommended Follow-Up: Review and update training on income data entry and ensure compliance with program requirements regarding income calculations.

Finding Text

During our compliance testing of federal awards, we noted that income information for 2 out of 30 patients tested was incorrectly entered into the system, leading to improper application of sliding fee discounts. Additionally, for 3 out of 30 patients tested, sliding fee calculations were accurate when using net income. However, the Sliding Fee Discount Program application explicitly requires gross income figures. Neither the program application form nor the related policies indicated that net income should be utilized.

Corrective Action Plan

MVCHS acknowledges that two of thirty patient accounts had miscalculated Sliding Fee Discount Schedule Program income, which resulted in the patients being placed on the wrong Slide. MVCHS Finance staff conducts periodic training with Front Office staff regarding the Sliding Fee Discount Program. The Sliding Fee Discount Schedule application process involves collecting income documents and calculating household income and family size. MVCHS Finance staff will enhance its periodic training, starting in April 2025 and quarterly thereafter, of the Sliding Fee Discount Schedule Program to ensure calculations are performed correctly. In addition, MVCHS Finance staff will develop an audit checklist and perform regular audits, starting in April 2025, of Sliding Fee Discount Schedule Program patient accounts in order to ensure accuracy and compliance. In addition to the above aforementioned error, MVCHS also acknowledges that the Sliding Fee Discount Schedule Program Application erroneously states that gross income is applied in calculating eligibility for the Sliding Fee Discount Schedule Program, when in fact, net income is applied. MVCHS appropriately applies net income when calculating eligibility for the Sliding Fee Discount Schedule Program. The Sliding Fee Discount Program Application has since been updated to indicate that net income will be applied. Front Office staff will receive updated training in order to ensure understanding and procedures for the Sliding Fee Discount Schedule Program.

Categories

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Other Findings in this Audit

  • 554939 2024-001
    Significant Deficiency Repeat
  • 1131380 2024-001
    Significant Deficiency Repeat
  • 1131381 2024-001
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
93.224 Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.57M
93.526 Grants for Capital Development in Health Centers $22,858
10.558 Child and Adult Care Food Program $4,111
93.778 Medical Assistance Program $3,841