Finding 634842 (2022-001)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2022-12-12

AI Summary

  • Core Issue: Health Centers failed to apply sliding fee discounts correctly for 8 out of 30 patients, violating federal guidelines.
  • Impacted Requirements: Compliance with Uniform Guidance and 42 CFR, specifically regarding the application of sliding fee discounts based on patients' ability to pay.
  • Recommended Follow-Up: Update electronic health record software and train staff to ensure accurate application of sliding fee discounts.

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 receiving 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 properly apply the sliding fee discounts for 8 patients out of a sample of 30 patients during the year ended June 30, 2022. Cause: There were deficiencies in internal controls to ensure that proper sliding fee discounts were applied to patient accounts in accordance with the Organization?s sliding fee scale. The sliding fee scale file was not properly utilized in the application of discounts provided to patients. Effect: Discounts were not properly applied to patient accounts. Questioned Costs: None reported Context/Sampling: For 8 of 30 patients selected for testing, the account had an incorrect discount applied. 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 the electronic health record software be updated to correctly apply sliding fee discounts as intended based on the federal poverty guidelines. It is recommended that staff be trained to review sliding fee discounts applied to ensure they are accurate. Views of Responsible Officials: Management concurs. Efforts will be made to implement corrective actions as recommended above. Contact Person: Shantelle Simpson, CEO Anticipated Date of Completion: January 31, 2023

Categories

Special Tests & Provisions Internal Control / Segregation of Duties

Other Findings in this Audit

  • 58398 2022-001
    Material Weakness Repeat
  • 58399 2022-002
    Material Weakness Repeat
  • 58400 2022-001
    Material Weakness Repeat
  • 58401 2022-002
    Material Weakness Repeat
  • 58402 2022-001
    Material Weakness Repeat
  • 58403 2022-002
    Material Weakness Repeat
  • 634840 2022-001
    Material Weakness Repeat
  • 634841 2022-002
    Material Weakness Repeat
  • 634843 2022-002
    Material Weakness Repeat
  • 634844 2022-001
    Material Weakness Repeat
  • 634845 2022-002
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $1.02M
93.224 Covid-19-Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $649,838
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $200,640
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $87,538
93.884 Grants for Primary Care Training and Enhancement $51,510
93.359 Nurse Education, Practice Quality and Retention Grants $24,300
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $7,648
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $7,250