Finding 598770 (2022-001)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-01-05

AI Summary

  • Core Issue: The Coast Community Health Center inaccurately applied sliding fee discounts to uninsured patients, failing to follow their own policy.
  • Impacted Requirements: Compliance with federal regulations regarding sliding fee discounts (42 USC 254(k)(3)(g); 42 CFR sections 51c.303(g) and 56.303(f)).
  • Recommended Follow-Up: Management should review and reinforce policies, and establish a regular self-audit process for sliding fee discount applications.

Finding Text

Finding 2022-001 Federal agency: U.S. Department of Health and Human Services Federal program title: Health Center Program Cluster CFDA Number: 93.224 and 93.527 Award Period: February 1, 2021 through January 31, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance and Compliance Criteria or specific requirement: Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR section 51c.303(g) and 42 CFR section 56.303(f)). Condition: Coast Community Health Center?s (the Center) sliding fee discount program provides discounts to uninsured patients based on the patient?s income and poverty levels. During our audit we noted one instance of an inaccurate sliding fee discount provided. Questioned costs: None. Context: A sample of 25 encounters were tested in relation to the sliding fee discount program. Of the 25 encounters tested 6 were found to not have received the proper sliding fee discount based upon the patient?s application or the application was missing. Cause: The Center did not comply with their sliding fee policy. Effect: Improper sliding fee determination and discount was applied to a patient?s account. Repeat finding: No. Recommendation: Management should review their policies and procedures with the personnel responsible for providing the sliding fee discount. We also recommend that management implement, monthly or quarterly, a self-audit process of newly approved sliding fee discount applicants and their associated patient record. Views of responsible officials: There is no disagreement with the audit finding.

Categories

Special Tests & Provisions Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 22328 2022-001
    Significant Deficiency
  • 22329 2022-001
    Significant Deficiency
  • 598771 2022-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $1.21M
93.224 Covid-19 American Rescue Plan Act Funding for Health Centers $389,500
93.498 Covid-19 Provider Relief Fund $367,804
93.224 Covid-19 Health Centers Coronavirus Aid, Relief, and Economic Security (cares) Act Funding $344,921
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $318,713
93.224 Covid-19 Fy 2020 Expanding Capacity for Coronavirus Testing (ect) $61,452