Finding Text
Health Center Program Cluster
CFDA Nos. 93.224 and 93.527
U.S. Department of Health and Human Services
Award No. 6 H80CS08239-14-01
Program Year 2023
Criteria or Specific Requirement – Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR sections 51c.303(g) and
42 CFR section 56.303(f))
Condition – Patients received a sliding fee discount that was inconsistent with the stated sliding fee discount categories under the Organization’s policy.
Questioned Cost – None
Context – A sample of 40 patient encounters was tested out of the population of 76,396 encounters. The sample is not, and is not intended to be, statistically valid. Of the 40 patient encounters tested, 2 were determined to have resulted in an improper sliding fee adjustment based on the Organization’s policy and screening of patient eligibility.
Effect – Sliding fee discounts were given to patients that were inconsistent with the Organization’s sliding fee policy.
Cause – The Organization did not comply with their sliding fee policy.
Identification as a Repeat Finding – Yes. Finding 2022-002.
Recommendation – Management should ensure that sliding fee adjustments are properly applied in accordance with the sliding fee policy and patient eligibility.