Finding Text
Assistance Listing Numbers 93.224 Consolidated Health Centers
Grant Number H80CS00112
US Department of Health and Human Services
Finding 2023-003
Compliance Requirement: Special Tests and Provisions-Sliding Fee Discounts
Type of Finding: Material Weakness
Criteria: Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient’s ability to pay and their eligibility. A patient’s eligibility to pay is determined on the basis of the official poverty guidelines.
Condition and Context: Documents to verify income could not be located for six of the twenty-five patients selected for testing. Also, there was no documentation of family size for five of the patients in this sample. The result is that we were unable to determine eligibility for a total of seven of the fourteen tested.
Cause: The condition can be attributed to turnover in patient management personnel and the fact that various files were moved off-site and stored without adequate communication to incoming personnel.
Effect or Potential Effect: Sliding fee discounts given could potentially be incorrect, or the patient could be ineligible.
Questioned Costs: None
Repeat Finding: The finding is a repeat finding (see prior year finding number 2022-006)
Recommendation: The Organization should be implementing and monitoring procedures to ensure that all supporting documents are kept for determining patient eligibility.
Views of Responsible Officials: Management agrees with the finding.