Finding 614434 (2022-001)

Significant Deficiency Repeat Finding
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2022-11-10
Audit: 34352
Organization: Hidalgo Medical Services (NM)

AI Summary

  • Core Issue: The organization misapplied sliding fee discounts based on patient income, leading to incorrect discounts being given.
  • Impacted Requirements: This finding relates to compliance with federal guidelines on sliding fee discounts as outlined in Title 42, Chapter 1, Subchapter D, Section 51c303(f).
  • Recommended Follow-Up: Implement a verification process to ensure discounts align with the organization's sliding fee policy to prevent future errors.

Finding Text

Findings Required to be Reported by the Uniform Guidance Finding 2022-001 ? Improper application of sliding fee discount CFDA Nos. ? 93.224 and 93.527 Federal Award ID # and Year ? 2 H80CS00744-19-00 Program Year 2022 Federal Agency Name: U.S. Department of Health and Human Services Type of finding Significant deficiency in internal control over compliance Criteria or Specific Requirement Special Tests and Provisions: Sliding Fee Discounts per Title 42 Chapter 1 Subchapter D Section 51c303(f) Condition The Organization?s sliding fee program provides discounts on patient services based upon the individual?s level of income. However, the Organization applied the incorrect discount based upon the individual?s income per the Organizations sliding fee discount policy. Cause Clerical error in updating and applying the sliding fee category in the billing system for the patient. Effect or Potential Effect Improper sliding fee discounts given to patients. Questioned Costs None Context or Perspective Information A sample of 40 patients were tested out of the total population of 1,994 encounters. The sampling methodology used is not statistically valid. Three patients received the incorrect sliding fee discount based upon their income level. Identification as a repeat finding, if applicable Yes, see prior year finding 2021-001. Recommendation We recommend that the Organization implement a verification process to ensure the sliding fee discounts being applied are in accordance with their sliding fee policy. Views of Responsible Officials and Planned Corrective Actions See corrective action plan

Categories

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

Other Findings in this Audit

  • 37992 2022-001
    Significant Deficiency Repeat
  • 37993 2022-001
    Significant Deficiency Repeat
  • 614435 2022-001
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.16M
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $898,000
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $230,242
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $191,105
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $125,250
93.053 Nutrition Services Incentive Program $110,395
93.958 Block Grants for Community Mental Health Services $84,236
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $65,674
93.461 Covid-19 Testing for the Uninsured $52,861
93.242 Mental Health Research Grants $42,731