Finding 946108 (2023-001)

Finding: 2023-001 Sliding Fee Discounts Federal Programs: Department of Health and Human Services Health Center Program Cluster Assistance Listing No. 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 either did not properly apply the sliding fee discount or did not properly document the sliding fee discount applied for three sliding fee patients tested. Cause: There were deficiencies in the internal controls that ensure proper documentation is obtained and that proper sliding fee discounts are applied to patient accounts in accordance with the Organization’s sliding fee policy and sliding fee scale. Effect: Discounts were not properly applied to certain patient accounts and proper documentation was not obtained to support the sliding fee discount applied to certain patient accounts. Questioned Costs: None reported. Context/Sampling: For 3 of 20 sliding fee patients selected for testing, the account either had an incorrect discount applied, or the documentation to support the discount applied was incomplete. 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: No Recommendation: It is recommended that proper training be given to employees and that the sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. Views of Responsible Officials: Management concurs. Efforts will be made to implement corrective actions as recommended above. Contact Person: April Briggs, CFO Anticipated Date of Completion: March 31, 2024