Finding Text
Federal Agency: Department of Health and Human Services
Federal Program Title: COVID-19 HRSA Uninsured Program
Federal Assistance Listing Number: 93.461
Type of Finding: Significant Deficiency over Compliance and Internal Control over Compliance
Condition: The System received reimbursement for testing of uninsured patients however it was later determined that those patients were insured.
Criteria: Funds for reimbursement are for the cost associated with COVID-19 testing and testing-related items for individuals who did not have any health care coverage at the time of service.
Questioned Costs: $439
Cause: The System’s controls around the determination of a patient’s insurance status were not operating effectively.
Effect: Noncompliance with the federal requirements around the determination of uninsured patients.
Recommendation: We recommend that the System review the submissions to HRSA to ensure that the patients they requested reimbursement for were in fact uninsured.
Views of responsible officials: We understand the finding. In future submissions, the System will review all patients to ensure that are uninsured.