Finding 59690 (2022-002)

Material Weakness
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-03-30

AI Summary

  • Core Issue: Ten out of sixty patients (16%) did not have proper income verification for sliding fee discounts.
  • Impacted Requirements: Annual income verification is mandatory for accurate patient billing under the sliding fee discount schedule.
  • Recommended Follow-Up: Management must strengthen controls to ensure annual income verifications are consistently performed for all eligible patients.

Finding Text

Finding 2022-002 ? Sliding Fee Determination and Related Patient Billing U.S. Department of Health and Human Services Assistance Listing No. 93.224, Consolidated Health Centers Program Cluster Condition: As part of our compliance testing procedures for the HRSA 330 grant programs, we tested sixty patients billed under a sliding fee discount schedule. Of the patients tested, ten patients (16%) were found to have exceptions as the income verification was either not performed or had not been performed within the past 12 months. Criteria: All section 330-funded health centers must prepare and apply a sliding fee discount schedule (SFDS), which adjust amount owed for health center services by eligible patients based on the patient?s ability to pay. Management is responsible to make sure controls are in place for patients to be charged in accordance with the SFDS and that income verifications are performed at least annually. Cause: Based on audit procedures performed, the income verification process was not performed on an annual basis for patients to be charged the correct amount for their service. Effect: The lack of controls over the income verification process could cause revenue to be over or understated. The impact of the ten patients that did not have appropriate documentation is not able to be quantified. Recommendations: The established policies and controls did not operate effectively in these instances. Management should ensure processes are in place to make sure the income verification process is being performed annually for each patient.

Corrective Action Plan

Views of responsible officials and corrective action plan: Due to significant turnover at Rural Health Corporation of Northeastern Pennsylvania, several income verifications were not completed in time. Additional hiring and training are required to ensure that these processes are followed. The outsourced billing company is scheduled to participate with an onsite visit the first week of April?23. The CFO acknowledges and is responsible for this corrective action plan.

Categories

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Other Findings in this Audit

  • 59691 2022-002
    Material Weakness
  • 59692 2022-002
    Material Weakness
  • 636132 2022-002
    Material Weakness
  • 636133 2022-002
    Material Weakness
  • 636134 2022-002
    Material Weakness

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) $1.43M
93.224 American Rescue Plan Act Funding for Health Centers $935,724