Finding 626131 (2022-001)

-
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-03-29

AI Summary

  • Core Issue: Noncompliance with the sliding fee discount schedule due to incorrect income entries and improper extensions for patients.
  • Impacted Requirements: Health centers must apply discounts based on patients' ability to pay, as per program criteria.
  • Recommended Follow-Up: Management should enhance internal controls, increase monthly audits, and ensure staff training on the sliding fee process.

Finding Text

2022-001 CFDA 93.224 / 93.527- Health Center Program ? Cluster Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) ? CFDA #93.224 Grants for New and Expanded Services Under the Health Center Program ? CFDA #93.527 Compliance Requirements: Special Tests and Provisions Type of Finding: Noncompliance Criteria Program requirements state that 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. Condition For the year ended June 30, 2022, we noted two instances of noncompliance with application of the sliding fee schedule. Cause Income was entered incorrectly by the person involved with the approval process and application of the sliding fee discount schedule resulting in the wrong discount being applied to the patient account. Additionally, a patient was granted a one-day extension when they should have been granted another temporary slide due to the length of time from the initial visit of 12/16/2020, in which a 30-day temporary slide was given, and the new visit date of 6/14/2022. Context During the audit there were 25 patients selected who received the sliding fee discount. Proper documentation and slide discounts applied were reviewed in accordance with Shawnee Health Service and Development Corporation?s sliding fee policy. Effect Oversight of the approval and application process is a key control over compliance. Lack of oversight can result in issues with the approval process and appropriately applying the sliding fee discount schedule. Recommendation We recommend management review their internal control procedures and determine where modifications may be needed in the proper training, education, approval, and application process. Responsible Official?s Response Management of Shawnee Health Service and Development Corporation concurs with the audit finding. Management will improve on their current processes while increasing the monthly internal audit sample from 20 applications per month to 30 applications per month. Additionally, management will implement a process to complete a 100% review of the sliding fee effective dates entered into the electronic patient management system. Also, prior to the anticipated completion date, management will require all staff who are involved in the sliding fee process to complete the established training module on data entry.

Categories

Internal Control / Segregation of Duties Special Tests & Provisions HUD Housing Programs

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $4.38M
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $3.14M
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $531,465
93.965 Coal Miners Respiratory Impairment Treatment Clinics and Services $355,840
93.747 Elder Abuse Prevention Interventions Program $85,270
93.332 Cooperative Agreement to Support Navigators in Federally-Facilitated and State Partnership Marketplaces $84,542
93.052 National Family Caregiver Support, Title Iii, Part E $62,037
93.994 Maternal and Child Health Services Block Grant to the States $55,421
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $41,071
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $19,335
93.042 Special Programs for the Aging_title Vii, Chapter 2_long Term Care Ombudsman Services for Older Individuals $17,478
93.041 Special Programs for the Aging_title Vii, Chapter 3_programs for Prevention of Elder Abuse, Neglect, and Exploitation $3,367
93.071 Medicare Enrollment Assistance Program $2,993
93.043 Special Programs for the Aging_title Iii, Part D_disease Prevention and Health Promotion Services $2,914