Finding 58450 (2022-002)

Health Center Program Cluster Assistance Listing Number(s) 93.224 and 93.527 U.S. Department of Health and Human Services Award No. H80CS00438 Criteria or Specific Requirement: Special Tests and Provisions Type of Finding: Significant Deficiency in Internal Control Over Compliance Condition: The Health Center must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible participants are adjusted based on the patient?s ability to pay. Questioned costs: n/a Context: The auditor selected a sample of 60 encounters. After the auditor tested selection #49, enough errors had been identified that the auditor stopped testing because the sample results could not support a low assessed level of control risk. The errors were a result of the misapplication of the sliding fee discount. The sliding fee discounts are based on the slide level code. In these instances, the sliding fee discount that was applied was not in accordance with the SFDS. Effect or Potential Effect: Either the Health Center or the patients may be paying more than required under the contract. Cause: The Health Center applied its SFDS inconsistently to the patients selected for testing. Recommendation: The Health Center should adopt an internal control procedure that allows them to consistently apply its SFDS to all eligible patients. Repeat Finding: 2021-001 Views of Responsible Officials: See page 12.