Finding 576681 (2023-003)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2023
Accepted
2023-10-10
Audit: 487
Organization: Sunrise Community Health (CO)

AI Summary

  • Core Issue: Two patients received incorrect sliding fee discounts due to a clerical error.
  • Impacted Requirements: Compliance with Title 42 Chapter 1 Subchapter D Section 51c303(f) regarding fee schedules and discounts based on patient ability to pay.
  • Recommended Follow-Up: Review and strengthen internal controls for determining and monitoring sliding fee discounts to prevent future errors.

Finding Text

Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), “Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient’s ability to pay.” Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified two visits that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization’s enrollment and billing department will work together to identify when any errors occur based on the documentation the patient provides. The enrollment team will verify the rate, and the billing and coding team will begin checking to ensure the rate that the patient was screened for is the rate the patient is being charged for and that the correct discount applies.

Categories

Internal Control / Segregation of Duties Subrecipient Monitoring

Other Findings in this Audit

  • 234 2023-001
    Significant Deficiency
  • 235 2023-002
    Significant Deficiency
  • 236 2023-003
    Significant Deficiency
  • 237 2023-001
    Significant Deficiency
  • 238 2023-002
    Significant Deficiency
  • 239 2023-003
    Significant Deficiency
  • 240 2023-001
    Significant Deficiency
  • 241 2023-002
    Significant Deficiency
  • 242 2023-003
    Significant Deficiency
  • 243 2023-001
    Significant Deficiency
  • 244 2023-002
    Significant Deficiency
  • 245 2023-003
    Significant Deficiency
  • 576676 2023-001
    Significant Deficiency
  • 576677 2023-002
    Significant Deficiency
  • 576678 2023-003
    Significant Deficiency
  • 576679 2023-001
    Significant Deficiency
  • 576680 2023-002
    Significant Deficiency
  • 576682 2023-001
    Significant Deficiency
  • 576683 2023-002
    Significant Deficiency
  • 576684 2023-003
    Significant Deficiency
  • 576685 2023-001
    Significant Deficiency
  • 576686 2023-002
    Significant Deficiency
  • 576687 2023-003
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.224 Consolidated Health Center, Affordable Care Act for New and Expanded Services $5.05M
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children (wic) $4.29M
93.224 Covid-19: American Rescue Plan Act Funding for Health Centers $3.50M
93.498 Covid-19: Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $644,424
93.527 Covid-19: Fy 2023 Expanding Covid-19 Vaccination $412,177
93.566 Refugee and Entrant Assistance - State Administered Programs $44,864
21.027 Covid-19: Coronavirus State and Local Fiscal Recovery Funds $28,980
14.218 Community Development Block Grants/entitlement Grants $14,154
10.561 Supplemental Nutrition Assistance Program (snap) $7,963
93.527 Consolidated Health Center, Affordable Care Act for New and Expanded Services $0