Finding Text
Federal Program: 93.224 Health Center Program Cluster Federal Agency: U.S. Department of Health and Human Services Criteria: Under 42 CFR Sections 51c.303(e), (f) and (g), 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. To verify this criteria, the compliance supplement has the suggested audit procedures which require the auditor to review a sample of patients treated. The Company should maintain patient files to support the patient's eligibility and that the patient charges were appropriately adjusted based on income and family size by appropriately applying the Company's sliding fee discount schedule. Condition: The Company did not require patients to complete necessary paperwork to verify the patient?s income and family size. Cause: The Company was unable to provide documentation that supported patient?s income and family size. As such, we are unable to determine whether the Company appropriately adjusted charges in accordance with its sliding fee discount schedule. Effect: The Company is not in compliance with federal regulations. Prevalence: The Company was unable to provide supporting documentation for 6 out of 25 patients sampled. Repeat Finding: Yes