Finding 609376 (2022-002)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-07-06

AI Summary

  • Core Issue: A significant deficiency in internal controls led to an incorrect sliding fee discount being applied to a patient visit.
  • Impacted Requirements: Compliance with Title 42 regulations requiring health centers to maintain accurate fee schedules and discounts based on patient ability to pay.
  • Recommended Follow-Up: Review and strengthen internal controls for the sliding fee process, and implement monthly random testing of discounts to ensure accuracy.

Finding Text

Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization will implement a procedure to randomly test ten Sliding Fee Discounts per service line monthly to ensure we are applying the correct discounts and the patient is paying the correct discounted amount. The Organization will train staff to test Sliding Fee Discounted visits going forward starting July 1, 2023.

Categories

Internal Control / Segregation of Duties Subrecipient Monitoring Significant Deficiency

Other Findings in this Audit

  • 32933 2022-001
    Significant Deficiency
  • 32934 2022-002
    Significant Deficiency
  • 32935 2022-001
    Significant Deficiency
  • 32936 2022-002
    Significant Deficiency
  • 32937 2022-001
    Significant Deficiency
  • 32938 2022-002
    Significant Deficiency
  • 32939 2022-001
    Significant Deficiency
  • 32940 2022-002
    Significant Deficiency
  • 609375 2022-001
    Significant Deficiency
  • 609377 2022-001
    Significant Deficiency
  • 609378 2022-002
    Significant Deficiency
  • 609379 2022-001
    Significant Deficiency
  • 609380 2022-002
    Significant Deficiency
  • 609381 2022-001
    Significant Deficiency
  • 609382 2022-002
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.224 Consolidated Health Center, Affordable Care Act for New and Expanded Services $1.50M
93.224 Covid-19: American Rescue Plan Act Funding for Health Centers $1.18M
93.959 Block Grants for Prevention and Treatment of Substance Abuse $210,684
93.217 Title X Family Planning Services $189,629
32.006 Covid-19: Telehealth Program $127,856
93.526 Covid-19: Grants for Capital Development in Health Centers $84,620
93.498 Covid-19: Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $74,198
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $73,185
93.436 Well-Integrated Screening and Evaluation for Women Across the Nation (wisewoman) $24,603
93.800 Organized Approaches to Increase Colorectal Cancer Screening $15,826
93.461 Covid-19: Hrsa Covid-19 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $13,211
21.027 Covid-19: Coronavirus State and Local Fiscal Recovery Funds $11,029
93.224 Covid-19: Fy 2020 Expanding Capacity for Coronavirus Testing (ect) $9,302
93.991 Preventive Health and Health Services Block Grant $3,515
93.426 Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke $2,962
93.366 State Actions to Improve Oral Health Outcomes and Partner Actions to Improve Oral Health Outcomes $500
93.439 State Physical Activity and Nutrition (span) $264
93.527 Consolidated Health Center, Affordable Care Act for New and Expanded Services $0