Finding Text
Finding 2023-003 Material Weakness in Internal Control Over Special Tests and
Provisions
Assistance Listing Numbers 93.224 Health Center Program
93.527 Affordable Care Act (ACA) for New and Expanded
Services Under the Health Center Program
Federal Agency U.S. Department of Health and Human Services, Health
Resources and Services Administration
Passthrough Agency N/A
Award Number/Year 2023Criteria
FFHC is responsible for keeping adequate supporting documentation of the calculation of patient
service fees for those patients who qualify for discounted fees based on family size and
household income. FFHC is also required to apply discounted fees accurately based on an
approved sliding fee scale that meets federal compliance requirements.
Condition
For AL No. 93.224, Health Center Program and AL 93.527, Affordable Care Act (ACA) for
New and Expanded Services Under the Health Center Program, we were not able to obtain
supporting documentation of the family size and household income for nine (9) of forty (40)
patients selected for testing. For the remaining thirty-one (31) patients we did not receive enough
supporting documentation to recalculate discounted fees in order to determine whether they were
in compliance with special tests and provisions for these programs.
Cause
During fiscal year 2023 sliding scale fees were not properly documented due to the allowance of
telehealth visits and limited staff available to collect and maintain proper documentation.
Effect
FFHC was not in compliance with the Special Tests and Provisions requirements applicable to
the Health Center Program and Affordable Care Act (ACA) for New and Expanded Services Under the
Health Center Program as prescribed by Uniform Guidance.
Questioned Costs
None reported.
Repeat Finding
Yes. See Finding 2022-002.Recommendation
We recommend that FFHC enforce its current policy and related internal control procedures to
ensure compliance with the requirement to provide discounted fees based on federally
determined poverty levels for fiscal year 2023.
Views of Responsible Officials and Planned Corrective Actions
See corrective action plan.