Finding 589447 (2022-002)

-
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-02-14

AI Summary

  • Core Issue: One patient was charged incorrectly due to a mistake in applying the sliding fee discount based on income.
  • Impacted Requirements: Health Centers must apply sliding fee discounts correctly for patients with incomes at or below 200% of the Federal Poverty Guidelines.
  • Recommended Follow-Up: Management should ensure accurate input of income information into the billing system and plans to bring billing in-house by March 31, 2023, for better oversight.

Finding Text

Criteria or specific requirement- 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 based on the patient's ability to pay as follows: a) Sliding fee discounts are applied to fees for health center services provided to all individuals and families with annual incomes at or below 200 percent of the Federal Poverty Guidelines (FPG); b) A full 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; c) Fees for health center services are discounted based on gradations in family size and income for individuals and families with incomes above 100 and at or below 200 percent of the FPG; and d) No sliding fee discount is applied to fees for health center services provided to individuals and families with annual incomes above 200 percent of the FPG. Condition - During the compliance testing of the Uniform Guidance "Special Tests and Provisions - Sliding Fee Discounts" one (1) selection out of a sample size of twenty-five (25) did not have the correct sliding fee applied to their services. Questioned Costs - None. Effect - The patient was not charged the correct amount for the services that were performed based on income information provided. Cause - Proof of income information was properly obtained from the patient, however, the information was not input into the billing system correctly so the sliding fee was not properly applied. Recommendation - Management should ensure that all information is input into the billing system correctly in order to avoid patients getting charged incorrect amounts for services. Management's Response - Management has already begun working to ensure that this does not happen again. Management feels as though this is partially due to using a third party to assist with billing and has plans to bring billing back in house where it can be better monitored. Billing is expected to be completely back in house by March 31, 2023.

Categories

Special Tests & Provisions

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $526,031
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $303,974
20.509 Formula Grants for Rural Areas and Tribal Transit Program $223,604
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $118,698
32.006 Covid-19 Telehealth Program $53,164
93.332 Cooperative Agreement to Support Navigators in Federally-Facilitated and State Partnership Marketplaces $50,000
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $44,342
93.959 Block Grants for Prevention and Treatment of Substance Abuse $36,953
93.994 Maternal and Child Health Services Block Grant to the States $36,047
21.027 Coronavirus State and Local Fiscal Recovery Funds $21,537
93.268 Immunization Cooperative Agreements $16,878
93.043 Special Programs for the Aging_title Iii, Part D_disease Prevention and Health Promotion Services $14,164
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $13,887
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $8,937
16.575 Crime Victim Assistance $7,055
93.069 Public Health Emergency Preparedness $5,919
66.032 State Indoor Radon Grants $2,226
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $2,137
93.071 Medicare Enrollment Assistance Program $453
66.605 Performance Partnership Grants $198