Finding 583350 (2023-002)

-
Requirement
N
Questioned Costs
-
Year
2023
Accepted
2023-12-29
Audit: 8893
Organization: Clinica Sierra Vista (CA)

AI Summary

  • Core Issue: Two patients received sliding fee discounts without having completed applications on file, violating federal requirements.
  • Impacted Requirements: Compliance with Title 2 U.S. CFR Part 200, which mandates proper documentation for sliding fee discounts.
  • Recommended Follow-Up: Enhance training for staff on discount application and implement regular reviews of patient accounts to ensure compliance and proper documentation.

Finding Text

2023-002 Application of Sliding Fee Discount Program Information Federal Organization U.S Department of Health and Human Services Assistance Listing Numbers 93.224 & 93.527 Health Center Program Cluster Award Numbers H80CS00540-21, H8FCS41201, H8GCS48292 Criteria [X] Compliance Finding [ ] Significant Deficiency [ ] Material Weakness Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Subpart F, Compliance Supplement, Part 4, Compliance Requirement N, Special Tests and Provisions states, “Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patients ability to pay.” Condition During our testing of sliding fee discounts for health center patients qualifying for reduced-charge visits, we identified two incidents where the slide fee was applied to a patient’s account without a completed application on file. Context This finding appears to be an isolated incident. A sample size of 25 patients included two who did not have an application on file. Cause The Organization did not follow its policies and procedures set in place to ensure the sliding fee schedule discount is correctly determined and applied to patient accounts. Effect Patients may have been granted the incorrect sliding fee discount. Questioned Costs None identified Recommendation We recommend continued effort in training personnel to be properly trained on applying appropriate sliding fee discounts based on the Organization’s approved policy and in compliance with the OMB Compliance Supplement requirements. An appropriate level of review should be conducted on patient accounts to ensure proper document retention, application of sliding fee discounts, and third-party insurance billing. Views of responsible officials and planned corrective action Management is in agreement with the audit finding.

Categories

Special Tests & Provisions Allowable Costs / Cost Principles Material Weakness Significant Deficiency

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $11.71M
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $3.72M
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $1.24M
93.778 Medical Assistance Program $657,678
93.556 Promoting Safe and Stable Families $611,512
93.994 Maternal and Child Health Services Block Grant to the States $504,674
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $357,333
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $319,036
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $287,654
14.267 Continuum of Care Program $261,805
93.917 Hiv Care Formula Grants $232,082
14.241 Housing Opportunities for Persons with Aids $208,008
93.332 Cooperative Agreement to Support Navigators in Federally-Facilitated and State Partnership Marketplaces $203,477
93.590 Community-Based Child Abuse Prevention Grants $175,818
84.181 Special Education-Grants for Infants and Families $159,175
93.153 Coordinated Services and Access to Research for Women, Infants, Children, and Youth $138,048
93.247 Advanced Nursing Education Grant Program $108,316
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $33,086