Finding 558164 (2024-002)

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Requirement
N
Questioned Costs
-
Year
2024
Accepted
2025-04-30
Audit: 355041
Organization: Hamdard Health Alliance (IL)
Auditor: Sikich CPA LLC

AI Summary

  • Core Issue: The Organization failed to keep documentation proving patient eligibility for sliding fee discounts.
  • Impacted Requirements: This is a noncompliance issue with the Special Tests and Provisions requirement for health center services.
  • Recommended Follow-Up: Management should enhance control procedures to ensure proper documentation is collected for each patient’s sliding fee eligibility.

Finding Text

2024-002: Health Centers Cluster – ALN# 93.224 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), ALN# 93.527 Grants for New and Expanded Services under the Health Center Program, June 30, 2024 - Special Tests and Provisions Criteria: The Organization 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: The Organization did not retain documentation or other evidence that patients were eligible for adjustment (discount) that was received. We consider this finding to be instances of noncompliance with regard to the Special Tests and Provisions compliance requirement. Effect: By not retaining the proper documentation it would possible for patients to receive services they were not eligible for. Questioned Costs: $0 Cause: Control procedures did not function as designed as applications were not completed by patients, leading to the finding with special tests and provisions. Recommendation: Management should review the control procedures in place related to sliding fee procedures and ensure proper documentation is collected for each patient to determine proper sliding fee eligibility. Views of Responsible Officials: Management agrees with the finding and a response is included in the Corrective Action Plan.

Corrective Action Plan

2024-002: Health Centers Cluster – ALN# 93.224 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), ALN# 93.527 Grants for New and Expanded Services under the Health Center Program, June 30, 2024 - Special Tests and Provisions Condition: The Organization did not retain documentation or other evidence that patients were eligible for adjustment (discount) that was received. Corrective Action Plan: Patient Service Representatives are responsible for ensuring sliding fee schedule docuemtns are current. We have implemented another layer of oversight to ensure moving forward, we will be able to identify any patients with expired documentation for the sliding fee scale application. The PSR Lead will run a monthly report in the EMR to capture any information that may have been inadvertently missed and will help us ensure updates are completed accurately and in a timely manner. A report was run initially for the current fiscal year and will be run monthly going forward to identify expired applications so we can update accordingly. Responsible Person for Corrective Action Plan: Director of Operations and PSR Leads Implmentation Date of Corrective Action Plan: April 16, 2025

Categories

Special Tests & Provisions Eligibility HUD Housing Programs

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.224 Health Center Program $1.43M
93.566 Refugee and Entrant Assistance_state Administered Programs $315,545
93.527 New and Expanded Services $233,833