Finding Text
2022-101 Special Tests and Provisions - Sliding Fee Scale Discounts Federal program: FAL 93.224/93.527 Health Centers Program Cluster U.S. Department of Health and Human Services Criteria: Patients applying for sliding fee scale (SFS) discounts should have their income levels adequately documented and accurately calculated, and patients should be given the proper discount based upon their income level in accordance with 42CFR Section 51c.303(f). Condition: The Center did not maintain proper documentation to substantiate SFS copays assigned to patients for three encounters out of forty tested. Cause: Staffing turnover Effect: For two of forty sliding fee patient encounters tested, the Center did not have patients' financial applications on file to support the SFS discount assigned. In addition, one SFS discount was not properly calculated. Recommendation: To help ensure that sliding fee discounts are properly calculated and documented, the Center should adhere to its formal written policies and procedures, and conduct random reviews of sliding fee scale applications in order to detect and correct errors or incomplete applications on a timely manner.