Finding Text
Finding 2022-001 ? Special Provisions Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Number: H80CS03983-18; H80CS03983-19 Award Periods: March 1, 2021 ? February 28, 2022; March 1, 2022 ? February 28, 2023 Type of Finding: 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: VNA did not have family size and patient income information on file in order to demonstrate the proper sliding fee scale had been assigned to a patient. Questioned Costs: None. Context: Three (3) of forty (40) transactions selected for testing. Cause: Family size and income information was not retained and entered into the electronic medical records prior to assigning the patient to a sliding fee scale. Effect: Patients may not be charged according to VNA?s sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Views of Responsible Officials: There is no disagreement with the audit finding.