Finding 578378 (2023-001)

Finding 2023-001 – Improper application of sliding fee discount CFDA Nos. – 93.224 and 93.527 Federal Award ID # and Year – 5 H80CS00744-21-00 Program Year 2023 Federal Agency Name: U.S. Department of Health and Human Services Type of finding Significant deficiency in internal control over compliance Criteria or Specific Requirement Special Tests and Provisions: Sliding Fee Discounts per Title 42 Chapter 1 Subchapter D Section 51c303(f) Condition The Organization’s sliding fee program provides discounts on patient services based upon the individual’s level of income. However, the Organization applied the incorrect discount based upon the individual’s income per the Organizations sliding fee discount policy. Cause Clerical error in applying the sliding fee discount adjustment in the billing system for the patient. Effect or Potential Effect Improper sliding fee discounts given to patients. Questioned Costs None Context or Perspective Information A sample of 40 patients were tested out of the total population of 2,283 encounters. The sampling methodology used is not statistically valid. Two patients received the incorrect sliding fee discount based upon their income level. Identification as a repeat finding, if applicable Yes, see prior year finding 2022-001. Recommendation We recommend that the Organization implement a verification process to ensure the sliding fee discounts being applied are in accordance with their sliding fee policy. Views of Responsible Officials and Planned Corrective Actions See corrective action plan