Finding 588 (2023-001)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2023
Accepted
2023-10-24
Audit: 1156
Organization: Valley Family Health Care, Inc. (ID)
Auditor: Harris CPAS

AI Summary

  • Core Issue: A patient was incorrectly charged a fee due to inconsistent application of sliding fee discounts.
  • Impacted Requirements: Health centers must apply a full sliding fee discount or a nominal charge for eligible patients under federal guidelines.
  • Recommended Follow-Up: Establish written billing procedures and controls to ensure accurate application of discounts for all eligible patients.

Finding Text

2023-001 Special Tests and Provisions Criteria: Special Tests and Provisions under the Department of Health and Human Services, Health Center Cluster, require that a full sliding fee discount is applied to fees for health center services provided to individuals and families with annual incomes at or below 100 percent of the FPG, or the health center applies only a nominal charge. Condition: One instance was noted where the patient was given a 75% discount of $18.75 on a $25 charge, leaving a balance of $6.25. The patient should have been charged a nominal fee $20. Cause: Inconsistent control activities related to the application of sliding fee discounts, resulting from a change in billing software and processes. Effect: The incorrect fee was charged to a patient. Recommendations: We recommend that the Organization establish written billing procedures and develop controls to ensure sliding fee discounts are consistently and accurately applied to all eligible patients. Views of Responsible Officials and Planned Corrective Action Plan: Management agrees with the finding and is in the process of implementing and documenting procedures to provide additional oversight on the application of sliding fee discounts.

Corrective Action Plan

Finding: 2023-001 Special Tests and Provisions Name of Contact Person: Cheri Hung, CFO Corrective Action: Valley Family Health Care, Inc. (VFHC) believes the significant deficiency noted in the Schedule of Findings and Questioned Costs was related to the implementation of our new billing software in 2022. It is important to note that in the instance identified, our patient was not harmed and was charged less per visit than indicated by our sliding fee discount guidance. In the short term, VFHC recognizes the need for additional training and heighted internal review of sliding fee discounts. We have submitted this issue to our 3rd party billing software firm to identify the system issues that led to the incorrect automated application of the sliding fee discount to the patient account. If our 3rd party billing software cannot identify and correct the system issues, VFHC is prepared to amend their board-adopted policy to a methodology that can be fully automated. Proposed Completion Date: We anticipate these actions to begin immediately and to be completed by the end of the 3rd quarter.

Categories

Special Tests & Provisions Internal Control / Segregation of Duties

Other Findings in this Audit

  • 577030 2023-001
    Significant Deficiency

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) $1.64M
93.498 Provider Relief Fund $1.10M
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $365,155
10.177 Regional Food System Partnerships (b) $31,567