Finding Text
Finding: 2022-001 Sliding Fee Discounts Federal Programs: Department of Health and Human Services Health Center Program Cluster CFDA 93.224 and 93.527 Criteria: Uniform Guidance, Special Tests & Provisions, Sliding Fee Discounts, 42 CFR, 56.303 Condition: Health centers that receive funding under the Health Center Program Cluster must prepare and apply a sliding fee discount so that the amounts owed for health center services by eligible patients are discounted based on the patient?s ability to pay. During compliance testing, it was determined that the Organization did not obtain and properly document all necessary elements required by the Organization?s policy. Cause: There were deficiencies in internal controls over the Organization?s sliding fee program. For certain patient accounts that were tested as part of the audit, the Organization was unable to substantiate that proper documentation was obtained and that proper sliding fee discounts were applied to patient accounts in accordance with the Organization?s sliding fee scale. Effect: Proper documentation was unavailable to substantiate that discounts were properly applied to patient accounts. Questioned Costs: None. Context/Sampling: For 3 of 48 patients selected for testing, incorrect discounts were provided. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: Yes Recommendation: It is recommended that employees are properly trained to document and apply the sliding fee discounts in accordance with the Organization?s sliding fee policy. It is also recommended that sliding fee discounts are reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. Views of Responsible Officials: Management concurs. These errors are a result of significant turnover within the Organization during the pandemic. Efforts will be made to implement corrective actions as recommended above. Contact Person: Jennifer Dittes, CEO Anticipated Date of Completion: July 31, 2023