Community Care of West Virginia, Inc.

EIN: 550599096

UEI: QGV7M7JRZG85

Data as of August 25, 2026

Community Care of West Virginia, Inc.10 audit years1 findings
10
Audit Years
1
Total Findings
0
Repeat Findings

FY 2020-06-30

Management decision deadline — for entities that funded this organization

The FAC accepted this audit on September 19, 2021. Under 2 CFR 200.521(d), a pass-through entity that provided federal funds to this organization for this audit period must issue a management decision on these findings by March 19, 2022 (1620 days ago).

What is a management decision? →
2020-001
Special Tests & Provisions

Health Center Program Cluster CFDA Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award No. 6 H80CS00080-19-06 Program Year 2020 Criteria of Specific Requirement ? Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR Sections 51c.303(g); and 42 CFR Sections 56.303(f)) Condition ? Patients who were eligible for sliding fee discounts under the Organization?s policy were given incorrect sliding fee discounts. Certain sliding fee discounts were incorrectly calculated based on the remaining balance rather than being calculated based on the gross charges as required by the Health Center Program Compliance Manual. Questioned Cost ? None Context ? A sample of 25 encounters were tested out of the total population of 143,728 eligible encounters. The sampling methodology used is not, and is not intended, to be statistically valid. Of the 25 encounters tested, 3 were determined to have resulted in an improper sliding fee adjustment based on the Organization?s approved sliding fee policy, approved sliding fee table and screening of patient eligibility. Effect ? Improper sliding fee discounts were given to patients. Cause ? The Organization did not comply with their sliding fee policy. Identification as a repeat finding, if applicable ? Not applicable. Recommendation ? Procedures should be implemented to ensure that eligible patients receive discounts in accordance with the sliding fee scale. Management should ensure that sliding fee discounts that are provided to patients are in compliance with the Health Center Program Compliance Manual.

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Full finding narrative

Health Center Program Cluster CFDA Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award No. 6 H80CS00080-19-06 Program Year 2020 Criteria of Specific Requirement ? Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR Sections 51c.303(g); and 42 CFR Sections 56.303(f)) Condition ? Patients who were eligible for sliding fee discounts under the Organization?s policy were given incorrect sliding fee discounts. Certain sliding fee discounts were incorrectly calculated based on the remaining balance rather than being calculated based on the gross charges as required by the Health Center Program Compliance Manual. Questioned Cost ? None Context ? A sample of 25 encounters were tested out of the total population of 143,728 eligible encounters. The sampling methodology used is not, and is not intended, to be statistically valid. Of the 25 encounters tested, 3 were determined to have resulted in an improper sliding fee adjustment based on the Organization?s approved sliding fee policy, approved sliding fee table and screening of patient eligibility. Effect ? Improper sliding fee discounts were given to patients. Cause ? The Organization did not comply with their sliding fee policy. Identification as a repeat finding, if applicable ? Not applicable. Recommendation ? Procedures should be implemented to ensure that eligible patients receive discounts in accordance with the sliding fee scale. Management should ensure that sliding fee discounts that are provided to patients are in compliance with the Health Center Program Compliance Manual.

Corrective Action Plan

Community Care of West Virginia, Inc. (CCWV) has reviewed its sliding fee discount policy and determined that revisions were needed in order to fully comply with the requirements set forth by Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR Sections 51c.303(g); and 42 CFR Sections 56.303(f)). As such, revisions were made to the policies listed below. These revised Financial Policies were approved by the Community Care of West Virginia, Inc.?s board of directors at its board meeting on April 26, 2021. 14.0 Patient Revenue and Receivable Monthly Process & Sliding Fee Discount Program ? Revisions to wording and headers/bold text were made in order to clarify compliance within the policy. 14.74 Sliding Fee Discount Program ? This policy was revised to bring the policy into compliance o Wording that the less than 100% FPL fee is ?nominal from a patient?s perspective? o Updates to the Sliding Fee Discount Scale for medical services to change from a percentage of charge to a flat fee for all sliding fee tiers. This was a change that has been discussed with CCWV auditors. It will allow sliding fee patients to have a fixed dollar amount they will be charged at each visit and will help them to better plan financially for getting needed medical services. This change will ensure that patients over 100% of FPL are paying more than the 100% FPL nominal fee. o Updates to the Sliding Fee Discount Scale for dental services to ensure that patients over 100% of FPL are paying more than the 100% FPL nominal fee. ? This policy was also updated to include specific language from the Site Visit Guide and HRSA Compliance Manual to clarify policy compliance. Grammatical updates and paragraph formatting/restructuring were made for better flow after additional wording from the Site Visit Guide and Compliance Manual were inserted. ? Additional revisions were made to clarify compliance within the policy. o Paragraph headers and/or bold text to clarify the sections for HRSA compliance. With the above revisions to CCWV?s Financial Policies, board approval, and implementation of the policies, we believe the noted audit finding has been rectified.

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