Finding Text
Federal Assistance Listing Number 93.224/93.527 Health Center Program
Special Tests and Provisions
Finding 2023‐002 – Noncompliance Related to Charging Incorrect Sliding Fee
Criteria: Fees for health center services are discounted based on gradations in family size
and income for individuals and families with incomes above 100% and at or
below 200% of Federal Poverty Guidelines. The Center’s sliding fee scale,
approved annually by the Board of Directors, is used to determine the patient’s
sliding fee.
Condition: For one of 25 encounters selected for testing, an incorrect calculation was used
to determine the household income, which resulted in the individual being
charged a lesser copay than they should have been charged.
Cause: Due to a calculation error, the Center calculated a patient’s annual income by
multiplying weekly income by 48 weeks instead of 52 weeks.
Effect: The patient encounter was discounted to a copay of $30 when the patient
qualified for a discounted copay of $35.
Questioned Costs: There are no questioned costs.
Context: This issue appears to be an isolated instance and is not systemic of a breakdown
in internal controls over special tests and provisions.
Repeat Finding: This is not a repeat finding.
Recommendation: We recommend that all staff involved in reviewing sliding fee applications be
reminded of the Center’s policy for calculating annual income based on support
provided by a patient.