UNICARE COMMUNITY HEALTH CENTER, INC

Repeat Finding: No Program Name: Health Center Program Cluster, Community Facilities Loans and Grants Cluster Assistance Listing #: 93.224, 93.257 Federal Agency: U.S. Department of Health and Human Services Type of Finding: Noncompliance, Significant Deficiency Compliance Requirement: Special Tests and Provisions Condition: Unicare Community Health Center, Inc. lacked adequate control over its sliding fee discount program to ensure applications were properly processed, recorded, and received the correct discount. For 3 of 25 patient files reviewed who received a sliding fee discount, the patient did not receive the proper discount. Criteria: Unicare Community Health Center, Inc. must have a policy and process in place to ensure that eligible patient charges are adjusted based on the patient’s ability to pay (42 USC 254(k)(3)(E), (F), and (G); 24 CFR sections 51c.303(e), (f), and (g)…

Corrective action: Finding Summary: The audit determined that the organization lacked adequate controls over its Sliding Fee Discount Program (SFDP) to ensure that applications were properly processed, recorded, and that eligible patients received the correct discount. Root Cause: Breakdowns in internal control execution, including lack of secondary review, over-reliance on manual processes, and insufficient monitoring. Corrective Actions: • Secondary Verification Control – Implement two-step eligibility and discount validation with sign-off. – 90 Days – Clinic Manager – Training by Compliance Consultant • System Controls – Configure EHR to enforce discount logic and prevent unauthorized overrides across all v…