Finding 577474 (2023-002)

Finding 2023 002: Sliding Fee CFDA Title: Health Center Cluster Assistance Listing Number: 93.224 Federal Award Year: 2/1/22 1/31/23 Federal Agency: U.S. Department of Health and Human Services Criteria Health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. Condition Wipfli reviewed 40 sliding fee charges to test if the amount charged, was calculated properly based on the patients’ income level and in compliance with Milwaukee Health Services’ sliding fee policy. Wipfli noted that 2 of the charges were not properly determined or information was not retained to determine if the charge was properly determined. Questioned Costs Undetermined. Cause and Effect Milwaukee Health Services, Inc. did not consistently follow the Organization’s policies for documenting and calculating charges for services when using the sliding fee scale. Patients may be charged the improper amount if proper procedures and controls are not in place to ensure the sliding fee is applied in accordance with Milwaukee Health Services’ sliding fee policy. Auditor’s Recommendation Review policies and implement and monitor controls surrounding the determination of the fees charged to patients to determine that fees are being determined in accordance with Milwaukee Health Services’ sliding fee policy. View of Responsible Officials Management agrees with the findings and has committed to a corrective action plan.