Finding Text
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Grants for New and Expanded Services Under the Health Center Program
Assistance Listing Number: 93.224/93.527
Federal Award Identification
Number: L2C42352-01-00
Award Periods: July 1, 2021 – June 30, 2023;
Type of Finding: Material noncompliance and Material weakness in internal control over compliance
Criteria:
Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)).
Condition:
Legacy incorrectly assessed and/or applied the sliding fee discount to patient encounters during the year.
Questioned Costs:
None.
Context:
Five (5) of sixty (60) encounters selected for testing.
Cause:
Unknown.
Effect:
Patients are not charged according to Legacy's sliding fee scale and their ability to pay.
Repeat Finding:
Yes.
Prior Year Finding:
2023-002.
Recommendation:
Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient.
Views of Responsible Officials:
There is no disagreement with the audit finding.