Finding Text
Information on the Federal Program Federal Program Name: Health Center Program Cluster Federal Agency: U.S. Department of Health and Human Services Federal Assistance Listing Title and Number: Consolidated Health Centers (Community Health Centers), 93.224; Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program, 93.527 Criteria or Specific Requirement: 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. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The Organization did not properly apply the sliding fee scale discount assigned to patients.Questioned Costs: $0 Context: For 4 out of 25 samples tested, the Organization incorrectly applied sliding fee scale discount assigned to patient, resulting to patients billed for the incorrect amounts. Effect: Patients received the incorrect sliding fee discount that they were eligible for based on income. Cause: The inaccuracies in the application of the sliding fee program discounts appear to be due to inadequate oversight and review. Repeat Finding: No Recommendation: The Organization should strengthen processes surrounding monitoring and self-review of the sliding fee discount application and determination. Management should periodically audit the sliding fee of patient encounters to ensure that discounts are appropriately determined and calculated. Views of responsible officials and planned corrective actions: See corrective action plan prepared by management attached.