Finding Text
Finding 2024-001 - Sliding Fee Discount Determination
Federal Agency: U.S. Department of Health and Human Services
Program Name: Health Center Program
Federal Assistance Listing Number: 93.224/93.527
Questioned Costs: N/A
Repeat Finding: No
Type of Finding: Noncompliance, significant deficiency
Compliance Requirement: Special Tests and Provisions - Sliding fee Schedule ("SFS")
Condition: Friends of Family Health Center lacked adequate controls over its sliding fee discount
program to ensure patients received the correct discount.
Criteria: Health Centers must maintain a sliding fee discount policy and apply a sliding fee
discount based on patient's ability to pay (42 USC 254(k((3)(E), (F), (G); 42 CFR
sections 53c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)).
Context: In testing patients receiving discounts under Friends of Family Health Center's sliding
fee schedule, we noted that for 1 of 40 patients selected for testing Friends of Family
Health Center incorrectly applied the discount or were put in the incorrect category
based on income and family size.
Cause: Friends of Family Health Center's review process was not effective in verifying the
sliding fee discount was correctly calculated and applied in accordance to the Friends
of Family Health Center's policy.
Effect: There is an increased risk that discounts may be given to patients not eligible to
receive a discount, or incorrect discounts may be provided for patients eligible to
receive a discount.
Recommendation: We recommend Friends of Family Health Center periodically review patients
receiving discounts under the sliding fee program to ensure that the correct
discounts are being applied based on the current sliding fee schedule.
View of Responsible
Officials:
Friends of Family Health Center will implement procedures for reviewing sliding fee
discounts and provide additional training to staff for calculating those discounts.