Finding Text
Finding 2022-003 ? Special Provisions Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Centers Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS02457-18; H80CS02457-19 Award Periods: February 1, 2021 ? January 31, 2022; February 1, 2022 ? January 31, 2023 Type of Finding: Compliance and significant deficiency in internal control over compliance Criteria: 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 (discounted) based on the patient?s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The organization had assessed two patients with a larger sliding fee discount than for which they were eligible based on their family size and income documentation. Questioned Costs: None. Context: Two (2) of Forty (40) transactions selected for testing. Cause: One patient did not have a current sliding fee assessment of family size and income and one patient was assigned a higher discount under an alternative sliding fee scale that allowed for a sliding fee discount up to 250% of the federal poverty guidelines, but which was ultimately rescinded and replaced with a sliding fee scale that does not exceed 200% of the federal poverty guidelines. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Views of Responsible Officials: There is no disagreement with the audit finding.