Finding 565393 (2025-001)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2025
Accepted
2025-06-19

AI Summary

  • Core Issue: One out of 40 sliding fee scale discount applications had an incorrect discount due to errors in patient attestation forms.
  • Impacted Requirements: Compliance with 42 CFR Section 51c.303(f) regarding accurate income documentation and discount calculations.
  • Recommended Follow-Up: Implement random reviews of SFS applications to identify and correct errors promptly.

Finding Text

2025-001 Special Tests and Provisions - Sliding Fee Scale Discounts Federal program: FAL 93.224 Health Center Program U.S. Department of Health and Human Services Federal grant number H80CS00416 Criteria: Patients applying for sliding fee scale (SFS) discounts should have their income levels adequately documented and accurately calculated, and patients should be given the proper discount based upon their income level in accordance with 42 CFR Section 51c.303(f). Condition: The Center requires patients that apply for the SFS discount to complete attestation forms that includes their household sizes and income levels, and these forms are then used to determine patients' SFS discounts. One patient attestation form out of 40 SFS patient encounters that we tested reflected an incorrect SFS discount. Cause: Unknown Effect: Due to incorrect attestation forms, we could not determine whether the Organization consistently provided patients with the proper discount based upon their income levels. Recommendation: To help ensure that SFS discounts are properly calculated and documented, the Center should perform random reviews of its SFS applications in order to detect and correct errors or incomplete applications on a timely basis.

Corrective Action Plan

2025-001 Special Tests and Provisions - Sliding Fee Scale Discounts Recommendation: To help ensure that sliding fee scale (SFS) discounts are properly calculated and documented, the Center should perform random reviews of its SFS applications to detect and correct errors or incomplete applications on a timely basis. Corrective Action Taken: 1. Immediate Review and Correction Upon determination of the finding, we conducted a full review of the affected patient account. 2. Staff Training All Outreach and Eligibility staff have received refresher training on the proper application of the sl iding fee scale, including income verification processes and documentation standards. This training now occurs as part of onboarding and annually thereafter. 3. Policy and Procedure Review We reviewed our internal policies and procedures to ensure clear guidance on income documentation requirements, allowable income sources, and how to properly apply the sliding scale. 4. Double-Verification Process A second-level review has been instituted for all new patient applications and renewals involving sliding fee scale determinations. This ensures that income is correctly assessed, and the appropriate fee level is applied before any charges are finalized. 5. Audit and Monitoring A quarterly internal audit process has been implemented to review a random sample of sliding fee scale determinations for accuracy. Findings from these audits will be tracked, and any trends will be addressed through targeted training or process changes. Ongoing Commitment: We are committed to continuous improvement and will monitor the effectiveness of these corrective actions over the next year. Adjustments will be made as necessary to ensure sustained compliance and fairness in our billing practices. Our goal is to uphold transparency and affordability in patient care while maintaining full adherence to regulatory standards. Contact Person: Tamie Olson, Chief Financial Officer Completion Date: Fiscal year ending January 31, 2026

Categories

Special Tests & Provisions

Other Findings in this Audit

  • 1141835 2025-001
    Significant Deficiency

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) $2.79M
93.526 Grants for Capital Development in Health Centers $35,050
93.527 Grants for New and Expanded Services Under the Health Center Program $13,765