Finding 624359 (2022-002)

U.S. Department of Health and Human Services, COVID-19 - Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2022-002 ? Special Tests and Provisions Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's family size and income. Condition The Center did not always appropriately apply the sliding fee discount based on income levels and family size. Context A test of 40 discount transactions was performed and resulted in three instances of sliding fee discounts not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Cause The Center did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None Identification of Repeat Finding Yes ? 2021-004 Recommendation The Center should ensure that internal controls are in place to effectively ensure that patients receive the correct sliding fee discount. View of Responsible Officials Management and the Board of Directors agree with the finding.