Finding Text
Program information: AL # 93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health centers must obtain sliding fee applications so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: We tested 60 sliding fee encounters and noted that 1 of 60 sliding fee encounters tested did not have a sliding fee application. In addition, 11 out of 60 encounters tested were discounted the incorrect amount. Questioned Costs: None. Cause and Effect: The Center failed to verify sliding fee applications were obtained for all patients receiving discounts and may have incorrectly charged sliding fee discounts to charges. Recommendation: We recommend that sliding fee applications be completed for each sliding fee patient. Procedures should be implemented to verify applications are completed before the encounter is billed. In addition, the Center could consider increasing its internal sampling throughout the year to verify sliding fee applications are obtained, completed, and agree to the discount applied. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached correct plan.