Finding 968087 (2023-004)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2023
Accepted
2024-04-01

AI Summary

  • Core Issue: The Organization misapplied the sliding fee discount schedule for patient services, affecting charges based on ability to pay.
  • Impacted Requirements: Compliance with federal regulations requiring accurate application of fee discounts (42 USC 254 and 42 CFR sections).
  • Recommended Follow-Up: Increase self-reviews of patient encounters and enhance training for front desk staff on patient information collection and verification.

Finding Text

Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Cluster Assistance Listing Number: 93.224 & 93.527 Federal Award Identification Number: H80CS00725-21 and H80CS00725-22 Award Periods: June 1, 2022 – May 31, 2023 and June 1, 2023 – May 31, 2024 Criteria: 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 incorrectly assessed and/or applied the sliding fee discount to a patient encounter during the year. Questioned Costs: None. Context: One of forty transactions selected for testing. Cause: Unknown. Effect: Patients are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Views of Responsible Officials: There is no disagreement with the audit finding.

Categories

No categories assigned yet.

Other Findings in this Audit

  • 391644 2023-003
    Significant Deficiency
  • 391645 2023-004
    Significant Deficiency
  • 391646 2023-005
    Significant Deficiency
  • 391647 2023-006
    Material Weakness
  • 391648 2023-007
    Significant Deficiency
  • 391649 2023-007
    Significant Deficiency
  • 968086 2023-003
    Significant Deficiency
  • 968088 2023-005
    Significant Deficiency
  • 968089 2023-006
    Material Weakness
  • 968090 2023-007
    Significant Deficiency
  • 968091 2023-007
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $5.28M
93.788 Opioid Str $1.30M
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $584,813
93.527 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $564,238
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $309,600
93.667 Social Services Block Grant $171,829
14.218 Community Development Block Grants/entitlement Grants $171,759
93.926 Healthy Start Initiative $140,725
93.332 Cooperative Agreement to Support Navigators in Federally-Facilitated and State Partnership Marketplaces $91,192
93.940 Hiv Prevention Activities_health Department Based $47,970
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $17,516
93.498 Provider Relief Fund $4,254