NEOMED CENTER, INC

Criteria: The Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) allow non-Federal entities to request advance payments, provided that the timing and amount of such advances are limited to the entity’s immediate cash needs and that funds are expended only for allowable costs incurred within the approved period of performance. Under cash management requirements, advance payments must be limited to the minimum amounts needed and timed to align with the actual, immediate cash requirements of the non-Federal entity (2 CFR §200.305(b)(1); 2025 OMB Compliance Supplement, Cash Management). Additionally, regarding the period of performance, federal awards may only be charged for obligations incurred during the approved period of performance stated in the Notice of Award, and costs incurred outside that period are considered unallow…

Corrective action: Condition: During the fiscal year ended June 30, 2025, NeoMed Center, Inc. used the advance payment method through the HHS Payment Management System (PMS) to obtain federal funds. In certain instances, drawdowns were requested based on aggregated projections and liquidity needs before specific eligible expenses were fully identified and ready for immediate disbursement. Although the funds were later applied to eligible expenses incurred within the authorized award periods, the absence of a documented, expense-level linkage at the time of each drawdown created a temporary timing difference between cash receipt and expense recognition. Accordingly, funds that did not meet revenue recognition…

Criteria: In accordance with 2 CFR § 200.305(b)(12), a recipient or subrecipient may retain up to $500 per year in interest earned on Federal funds for administrative expenses. Any interest earned in excess of $500 per year must be remitted annually to the Department of Health and Human Services (HHS) through the Payment Management System (PMS) via the Automated Clearing House (ACH) network or Fedwire Funds Service. This requirement applies regardless of whether the recipient or subrecipient was paid through PMS. Condition: For the fiscal year ended June 30, 2025, the entity earned interest on Federal funds in excess of the $500 allowable retention limit. The entity did not remit the excess interest to the Payment Management System (PMS) within the required timeframe. The amount of excess interest retained and not remitted totaled $1,417.45. Effect: Noncompliance with 2 CFR § 200.3…

Corrective action: Condition: For the fiscal year ended June 30, 2025, NeoMed Center, Inc. earned interest on federal funds more than the $500 annual amount permitted under 2 CFR §200.305(b)(12). The excess interest was not remitted timely to the U.S. Department of Health and Human Services (HHS) through the Payment Management System (PMS). This condition resulted from the lack of a formalized control process to periodically monitor interest earned on federal cash balances and to identify when the allowable annual retention threshold had been exceeded. Planned Corrective Action: Management implemented formal written policies and procedures governing the monitoring of interest earned on federal funds in acc…

Criteria: Health centers receiving federal funding under the Health Center Program (93.224) and Ryan White Part C (93.918) are required to maintain and consistently apply a sliding fee discount program in accordance with federal regulations and program guidance. Specifically, 42 CFR §51c.303(f) requires health centers to have a schedule of fees and discounts based on patients’ ability to pay and to apply the schedule consistently. The HRSA Health Center Program Compliance Manual, Chapter 9, mandates documented eligibility determinations, defined timeframes for eligibility reassessment, proper application of the sliding fee scale, and retention of documentation. Similarly, the Ryan White HIV/AIDS Program Part C Manual requires eligibility determinations and fee assessments consistent with approved policies and program requirements. Additionally, federal standards under 2 CFR §200.303 req…

Corrective action: Condition: During audit testing of the Sliding Fee Discount Program for the fiscal year ended June 30, 2025, NeoMed Center, Inc. identified deficiencies in the documentation, retention, and supervisory review of patient eligibility determinations. Specifically, patient financial information was updated in a manner that overwrote prior eligibility evaluations, resulting in the loss of historical eligibility records. In addition, patient files were not consistently closed or retained in accordance with established policies and federal program requirements. These conditions reflected weaknesses in internal controls over eligibility documentation and supervisory oversight, which increased the …