UNION COMMUNITY CARE

Finding No. 2025-001 - Sliding Fee Determination and Related Patient Billing U.S. Department of Health and Human Services Assistance Listing Number 93.224 Consolidated Health Centers Program Cluster Criteria: All section 330-funded health centers must prepare and apply a sliding fee discount schedule (SFDS), which adjusts amounts owed for health center services by eligible patients based on the patient’s ability to pay. The National Health Services Corps (NHSC) statute mandates that NHSC-approved sites “not deny requested health care services, and shall not discriminate in the provision of services to an individual because the individual is unable to pay for the services.” It stipulates, “the entity shall prepare a schedule of discounts (including, in appropriate cases, waivers) to be applied to the payment of such fees or payments. In preparing the schedule, the entity shall adjust t…

Corrective action: We agree and plan to address this with improved processes, procedures, and training.

SECTION III ? FEDERAL AWARD FINDINGS AND QUESTIONED COSTS Material Weakness Finding No. 2021-001 ? Sliding Fee Determination and Related Patient Billing Assistance Listing No. 93.224 Consolidated Health Centers Program Cluster U.S. Department of Health and Human Services Compliance Requirement: Special Test Type of Finding: Material noncompliance Criteria: All section 330-funded health centers must prepare and apply a sliding fee discount schedule (SFDS), which adjusts amounts owed for health center services by eligible patients based on the patient?s ability to pay. The National Health Services Corps (NHSC) statute mandates that NHSC-approved sites ?not deny requested health care services and shall not discriminate in the provision of services to an individual because the individual is unable to pay for the services.? It stipulates, ?the entity shall prepare a schedule of discounts (…

Corrective action: During the year there was no billing staff at each location to train and support front desk personnel with sliding fee applications at the time of service. This led to errors and inconsistencies with income verification and sliding fee determination. On November 1, 2021, Welsh Mountain Health Centers, Inc. d/b/a Union Community Care, placed billing staff at each site location to support, train and review sliding fee applications with front desk personnel at time of service. This will improve internal controls and enhance staff training. On-site billing staff will also be available to review and discuss applications with patients. We will also conduct internal audits of sliding fee applicatio…