Core Issue: A patient’s non-covered charge was incorrectly submitted for state tax offset, leading to potential billing errors.
Impacted Requirements: Federal guidelines prohibit balance billing uninsured patients for remaining charges.
Recommended Follow-Up: Implement controls to ensure no balance billing occurs for uninsured patients after HRSA payments.
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 mistakenly submitted one of the patient’s non-covered charges from HRSA for North Carolina Debt payment to be offset with state tax refund.
Criteria: The remaining statement balance should not be balance billed to the patient.
Questioned Costs: $370
Cause: The System did not have the control in place to ensure the patient balance was not transferred.
Effect: Noncompliance with the federal requirements around the determination of uninsured patients.
Recommendation: We recommend that the System ensure that remaining statement balance for uninsured testing is not balance billed to the patient.
Views of responsible officials: We understand the finding. All balances remaining after HRSA payments will be reviewed and adjusted to zero.
Categories
Questioned CostsSignificant DeficiencyInternal Control / Segregation of Duties