Finding Text
Finding: 2023-002 Sliding Fee Discounts
Federal Programs: Department of Health and Human Services
Health Center Program Cluster
CFDA 93.224 and 93.527
Criteria: Uniform Guidance, Special Tests & Provisions, Sliding Fee Discounts, 42 CFR, 56.303
Condition: Health Centers receiving funding under the Health Center Program Cluster must prepare and apply a sliding fee discount so that the amounts owed for health center services by eligible patients are discounted based on the patient’s ability to pay. During compliance testing, it was determined that the Organization did not properly apply the sliding fee discounts or incorrect family size was entered for 2 patients out of a sample of 20 patients during the year ended June 30, 2023.
Cause: There were deficiencies in internal controls designed to ensure that proper sliding fee discounts were applied to patient accounts in accordance with the Organization’s sliding fee scale. The sliding fee scale file was not properly utilized in the application of discounts provided to certain patients.
Effect: Discounts were not properly applied to patient accounts.
Questioned Costs: None reported.
Context/Sampling: For 2 of 20 self-pay patients selected for testing, the account had an incorrect discount applied or the family size incorrectly entered. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue.
Repeat Finding from Prior Year: Yes
Recommendation: It is recommended that staff be trained to review sliding fee discounts applied to ensure they are accurate. In addition, it is recommended that supervisory level personnel select and review a sample of sliding fee applications and discounts to ensure that staff are properly applying the discounts.
Views of Responsible Officials: Management concurs. Efforts will be made to implement corrective actions as recommended above.
Contact Person: Shantelle Simpson, CEO
Anticipated Date of Completion: January 31, 2024