Finding Text
Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00192 Award Period: January 1, 2022 ? December 31, 2022 Type of Finding: Compliance and Significant deficiency in internal control over compliance Criteria: 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 patient?s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The Organization charged one (1) patient the full self-pay rate for a visit instead of the appropriate sliding fee discounted rate based on the patient's eligibility determined by their family size and income. Questioned Costs: None. Context: This condition occurred in one (1) of forty (40) transactions selected for testing. Cause: Patient had a credit balance on their account which was incorrectly applied to the full charge for the patient's visit. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should refine and expand its internal audits of patient visits to identify instances where a patient was either assigned to the incorrect sliding fee category or billed the incorrect charges. Views of Responsible Officials: There is no disagreement with the audit finding.