Finding Text
Health Center Program Cluster; Federal Assistance Listing No. 93.224; U.S. Department of Health & Human Services; grant number H80CS00562; budget periods May 1, 2021, through April 30, 2022. Criteria or specific requirement: Special Tests and Provisions ? 42 CFR, Part 56.303(e), (f) and (g). Health centers receiving funds under the Health Center Program Cluster are required to have prepared a schedule of fees or payments for the provision of its services designed to cover its reasonable costs of operation and a corresponding schedule of discounts adjusted on the basis of the patient?s ability to pay, to make every reasonable effort, including the establishment of systems for eligibility determination, billing and collection, and to secure from patients payments for services in accordance with the schedule of fees and discounts. Condition: We noted during our testing of compliance with federal awards that the Center did not apply the sliding fee discounts properly to three patients out of a sample of 25 patients for the year ended April 30, 2022. Questioned cost: None. Context: From financial records for patients treated during the audit period, we selected 25 discounts for testing. This sample was not, and was not intended to be, a statistically valid sample. The Center?s management prepared a schedule of discounts adjusted on the basis of the patient?s ability to pay; such schedule was periodically updated and approved by the Center?s board of directors; and the schedule was uploaded into the Center?s billing system. However, there were errors when comparing the income or family information entered into the system during the year ended April 30, 2022. For 3 of the 25 accounts selected for testing, the account had an incorrect discount applied. Effect: Discounts were not properly applied to patient accounts. Cause: The errors for the three patients? accounts were due to incorrect information being noted in the patients account. Identification as a repeat finding, if applicable: N/A. Recommendation: We recommend management should periodically test the application of the sliding fee to patient accounts.