Finding 58481 (2022-001)

Material Weakness
Requirement
N
Questioned Costs
$1
Year
2022
Accepted
2023-09-29
Audit: 54032
Organization: Municipality of Skagway (AK)
Auditor: Bdo USA PC

AI Summary

  • Core Issue: There was a lack of required sliding fee applications for individuals receiving discounts, leading to potential incorrect billing.
  • Impacted Requirements: The agency must maintain proper documentation for sliding fee discounts as per regulatory standards.
  • Recommended Follow-Up: Management should ensure all necessary supporting documents are retained and has started new processes to address this issue.

Finding Text

Finding 2022-001 Special Tests and Provisions ? Internal Control Over Compliance ? Material Weakness in Internal Control Over Financial Reporting and Material Noncompliance Agency Department of Health & Human Services ALN 93.224 / 93.527 Program Name Health Center Program Cluster Award Year 05/01/2022 through 04/30/2023, 04/01/2021 through 03/31/2023, and 04/01/2020 through 03/31/2022 Award Number H80CS08232, H8DCS35378, H8FCS41723 Criteria Borough is required to retain a sliding fee application for individuals that have applied and qualify to receive sliding fee discount. Condition When completing the test work there was an individual that was on the report for receiving the sliding fee rates but they did not have the application in their file. The sliding fee application was not available for sample selected for testing. During the testwork performed one out of nine items tested did not have support to qualify for sliding fee Cause Controls were not operating to ensure proper supporting documentation was maintained in accordance with sliding fee requirements. Effect or Potential Individuals may have paid an incorrect portion of the services provided. Questioned Costs $301 Context One sample out of nine items tested did not have support for the sliding fee scale applied against the billing. A rate was applied, but the documentation of the support for the rate was not retained. Identification as a Repeat Finding No Recommendation Management should ensure supporting documentation is maintained for all based on regulatory and reporting requirements. Views of Responsible Officials Management concurs with the findings. Management has implemented new processes to ensure retention of required documents.

Corrective Action Plan

Finding 2022-001 ? Special Tests and Provisions ? Internal Control Over Compliance ? Material Weakness in Internal Control Over Financial Reporting and Material Noncompliance Issue: A missing application from the audit sample was shredded in error before being scanned into the patient?s Electronic Health Records (EHR) chart, resulting in a documentation gap. Objective: To prevent the recurrence of missing sliding fee applications by implementing a revised process that ensures all applications are properly documented and stored in the Electronic Health Records (EHR) system. Corrective Action Plan: Reception staff will continue to manage applications and supporting documentation, but once an application is complete and scanned to the patient?s chart, it will be stamped ?SCANNED? and passed to the Accounts and Benefits Specialist (ABS). The ABS will verify that the packet has been added to the patient?s EHR chart and the correct slide is placed on the account. Only application packets that are stamped ?SCANNED? will be shredded by the ABS. If the packet is not stamped, another review will be done by ABS to ensure a complete record in EHR prior to shredding. All incomplete applications will continue to be kept in a physical file by reception staff with date stamps and notes of what documentation is missing. Once an application is complete it will follow the steps outlined above. Expected Completion Date: Fiscal Year 2023

Categories

Questioned Costs Special Tests & Provisions Material Weakness Reporting Internal Control / Segregation of Duties

Other Findings in this Audit

  • 58482 2022-001
    Material Weakness
  • 58483 2022-001
    Material Weakness
  • 634923 2022-001
    Material Weakness
  • 634924 2022-001
    Material Weakness
  • 634925 2022-001
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $781,036
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $387,036
21.027 Coronavirus State and Local Fiscal Recovery Funds $179,515
21.032 Local Assistance and Tribal Consistency Fund $153,938
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $62,827
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $40,613
10.665 Schools and Roads - Grants to States $34,761
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $21,511