Finding 580702 (2022-002)

2022-002 Sliding Fee Discount Determination CFDA Number: 93.224 Program: Community Health Center Cluster Compliance Requirement: (N) Special Tests and Provisions Criteria: Federal grant compliance provisions require that the Center correctly identify a patient's ability to pay and that the rates for services be adjusted accordingly based on the sliding fee schedule. The Center is required to follow its sliding fee policy when providing discounts to eligible patients. Finding/ Condition: In our sample of tested items, patient information was inadequate to determine the proper sliding fee discount or patients were given incorrect discounts based on information provided. Questioned Cost: None. Effect: Lack of strict enforcement of the policy of sliding fee eligibility determination and compliance may have resulted in the Center providing discounted services greater to or less than the appropriate amounts to beneficiaries. Cause: In the prior year the Center became aware of deficiencies in the sliding fee program through the annual external audit. By the time the deficiencies were reported there was not enough time to implement corrective actions for the current year. Thus, the same deficiencies were found in consecutive years. Repeat Finding: This is a repeat finding. Please see finding 2021-002. Recommendation: Training should be provided to employees on the sliding fee program requirements. Views of Responsible Officials and Corrective Action Plan: The Center agrees with the finding and will implement additional controls to ensure that this does not recur. Please refer to the corrective action plan on page 35.