Finding 58680 (2022-003)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2022-12-12
Audit: 54258
Organization: Open Door Health Services, INC (IN)
Auditor: Forvis LLP

AI Summary

  • Core Issue: The sliding fee discount schedule was not applied correctly, leading to billing errors for eligible patients.
  • Impacted Requirements: Internal controls over the application of discounts were inadequate, resulting in five errors out of a sample of 60.
  • Recommended Follow-Up: Review and enhance current processes to ensure accurate application of discounts based on patient information.

Finding Text

2022-003 Federal Program Name: Health Center Program Cluster Federal Agency U.S. Department of Health and Human Services CFDA Title and Number Health Center Program Cluster, CFDA 93.224 and 93.527 Criteria or Specific Requirement: Special Tests and Provisions - The Organization must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: Application of the sliding fee discount was not appropriately applied. Questioned Costs: No Context: The Organization establishes and maintains internal controls over the application of the sliding fee discounts applied in accordance with its policies so that eligible patients receive discounts based on their ability to pay. During the course of the audit, there were five errors out of 60 in the application of the sliding fee discount. The sample selected was not a statistically valid sample. Effect: Patients were billed incorrect amounts which were subsequently corrected. Cause: Internal controls surrounding application of the sliding fee discount were not adequately applied to ensure that discounts were appropriately applied. Repeat Findings: Yes Recommendation: We recommend that the Organization evaluate current review processes and controls for the application of the sliding fee discount to ensure that all information collected from patients is reviewed and the appropriate slide is processed. Views of Responsible Officials and Planned Corrective Action: We concur. The impacted accounts have subsequently been corrected or are in process to be corrected. Management continues to evaluate current controls related to the application of the sliding fee discount to ensure that appropriate review is completed and discounts are applied correctly.

Categories

Special Tests & Provisions Internal Control / Segregation of Duties

Other Findings in this Audit

  • 58679 2022-003
    Material Weakness Repeat
  • 58681 2022-003
    Material Weakness Repeat
  • 635121 2022-003
    Material Weakness Repeat
  • 635122 2022-003
    Material Weakness Repeat
  • 635123 2022-003
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $2.68M
93.224 Covid-19 - Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.60M
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $1.14M
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $934,995
93.217 Family Planning_services $208,247
93.558 Temporary Assistance for Needy Families $155,691
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $100,000
93.667 Social Services Block Grant $72,154