MARANA HEALTH CENTER, INC

We randomly selected forty sliding fee discounts to test for compliance. Five of the forty sliding fee selections had instances in which the sliding fee discount was improperly adjusted in the Practice Management System (“PMS”), resulting in a net undercharge of $104.

Corrective action: The sliding fee determination will be reviewed by the front desk staff thoughtfully to ensure the proper charge to the patient. o Once the patient is screened and determined to be eligible for the Sliding Fee program by the front office, the patient will complete the Sliding Fee application and self-declaration of income and family size. The front office will verify the application, determine the scale for which the patient qualifies, and verify with the Center’s practice management system. The lead biller will review all uploaded documents and approve the sliding fee in real time. o Additional training will take place with front desk personnel. The corrective action outlined above will be m…

During single audit planning, we performed a reconciliation of the drawdown report per the PMS for the major program to the balance reported on the SEFA and discovered that there was a drawdown that was not included in the balance on the SEFA specifically for award number H80CS00231. We inquired of management regarding the additional drawdown and discovered that this drawdown was initiated by the CEO and was not supported by way of expenditures incurred or any intent to expend the funds for a specific purchase within 30 days of receipt from the granting agency.

Corrective action: The Controller will review the detailed information related ot the drawdown to ensure the amount charged to the specific grant is allowable, reasonable and properly supported prior to when the drawdown is requested.

We randomly selected forty sliding fee discounts to test for compliance. One of the forty sliding fee selections did not have a sliding fee scale application on file at the date of service. Also, there were four instances in which the sliding fee discount was improperly adjusted in the Practice Management System (“PMS”), resulting in a net undercharge of $45.

Corrective action: The sliding fee determination will be reviewed by the front desk staff thoughtfully to ensure the proper charge to the patient. Once the patient is screened and determined to be eligible for the Sliding Fee program by the front office, the patient will complete the Sliding Fee application and self declaration of income and family size. The front office will verify the application, determine the scale for which the patient qualifies, and verify with the Center's practice management system. The lead biller will review all uploaded documents and approve the sliding fee in real time. Additional traning will take place with front desk personnel.

2022-001: Significant Deficiency in Internal Control Over Compliance and Compliance Over Application of Sliding Fee Discounts Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Health Centers Cluster CFDA Number: 93.224 and 93.527 Criteria: The Health Centers Program, 42 U.S.C. ? 245b(k)(3)(G)(i) states that ?the center has prepared a schedule of fees or payments for the provision of its services consistent with locally prevailing rates or charges and designed to cover its reasonable costs of operation and has prepared a corresponding schedule of discounts to be applied to the payment of such fees or payments, which discounts are adjusted on the basis of the patient?s ability to pay.? Condition: During our testing of sliding fee discounts for health center, there were two instances in which the sliding fee was calculated incorrectly. Context: We ra…

Corrective action: Marana Health Center, Inc. respectfully submits the following corrective action plan for the year ended June 30, 2022. Audit Period: July 1, 2021 - June 30, 2022 Category: GENERAL MARANA HEALTH CENTER, INC. AD-2-010 Procedure: Sliding Fee Schedule Patient Demographic Changes Page 1 of 2 I. PURPOSE: The Sliding Fee Schedule (SFS) Patient Demographic Changes process was created to ensure any patient who is certified on MHC Healthcare's (MHC) SFS and has changes on their Patient Profile (Profile) to their Family Size and/or Income are referred to the Outreach Department (OR) and that these changes are only made by an OR employee or the OR Manager. II. PROCESSES: A. Front Office (FO) s…