Finding 611158 (2022-001)

Finding Number: 2022 001 Finding Type: Significant deficiency in internal control over compliance and compliance Information on the Federal Program: Program Name: Health Center Program Cluster (AL numbers 93.224 and 93.527) Grant Award: 5 H80CS00508 20 from June 1, 2021 through May 31, 2022 and 2 H80CS00508 21 from June 1, 2022 through May 31, 2023 Agency: U.S. Department of Health and Human Services, Health Resources and Services Administration Pass Through Entity: N/A Criteria: In accordance with Section 330(k)(3)(G) of the Public Health Service Act (42 U.S. Code ? 254b), as an FQHC, the Organization must have a sliding fee discount program in which the Organization?s fee schedule is discounted based on a patient?s ability to pay. Condition and Context: The Organization has not applied sliding fee discounts to patient charges consistent with its sliding fee discount program. Through testing a statistically valid sample of transactions for the appropriate application of the Organization's sliding fee discount program to 25 individual patient balances, we noted the sliding fee discount applied was not consistent with the Organization's sliding fee discount policy for three patients. For one of the patients, an incorrect discount was applied to the patient account. For the other two patients, the sliding fee discount category awarded to each patient was not consistent with the category that each patient was eligible for based on the patient's family size and income. Cause and Effect: The Organization has limited internal monitoring procedures established for ensuring compliance with the sliding fee discount program. The errors resulted in the following deviations from the Organization's sliding fee discount program: ? One patient was responsible to pay $10 more than required ? One patient was responsible to pay $10 less than required ? One patient responsible to pay $19.60 less than required Questioned Costs: None Repeat Finding: Yes, 2021 002 Recommendation: We continue to recommend the Organization develop routine internal monitoring procedures to perform periodic testing of sliding fee discounts to help ensure the discounts are provided consistent with the Organization?s sliding fee discount program. Views of a Responsible Official and Corrective Action Plan: Management agrees with the finding. Routine and timely documented reviews of sliding fee discounts will be completed to ensure compliance with the Organization's sliding fee discount program.