HEALTHPOINTNon-Profit

Finding 2021-001 Reporting Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Provider Relief Fund Program Assistance Listing Number: 93.498 Award Period: 1/20/2020 ? 6/30/2021 Type of Finding: Significant Deficiency in Internal Control over Compliance and Compliance Criteria or specific requirement: Per 2 CFR 200.302, the state's and the other non-Federal entity's financial management systems, including records documenting compliance with Federal statutes, regulations, and the terms and conditions of the Federal award, must be sufficient to permit the preparation of reports required by general and program-specific terms and conditions; and the tracing of funds to a level of expenditures adequate to establish that such funds have been used according to the Federal statutes, regulations, and the terms and conditions of the Federal award. Further, the financial management system of each non-Federal entity must provide accurate, current, and complete disclosure of the financial results of each Federal award or program in accordance with the reporting requirements. According to ?200.303 Internal controls of 2 CFR Part 200, the non-Federal entity must establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. Condition: Report submission was inaccurate. HealthPoint?s calculation of lost revenues only factored dental revenue loss, however medical revenues should have been factored into the lost revenue calculation as well. Questioned Costs: None Context: This was identified during our testing of the HRSA PRF Phase 1 Special Report. The report submitted did not accurately reflect the classification of the final COVID expenses or loss revenue identified to meet the terms and conditions of the award. Cause: Insufficient internal controls and procedures to evaluate the federal award requirements and review of the final submission. Effect: HealthPoint?s reporting did not accurately reflect the use of funds. Recommendation: HealthPoint should ensure that program managers compare all program reports to the reporting requirements within the grant documents to ensure all quantitative and qualitative information is appropriately included prior to submittal to the oversight agency. Views of responsible officials: There is no disagreement with the audit finding.

Finding 2021-002: Application of Sliding Fee Discounts Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Health Center Program Cluster Program Assistance Listing Number: 93.224 and 93.527 Award Period: 4/1/2020 ? 3/31/2021 and 4/1/21 ? 3/31/2022 Type of Finding: Significant Deficiency in Internal Control over Compliance and Compliance Criteria or specific requirement: Per 42 CFR 51c.303(f), the community health center must have prepared a schedule of fees or payments for the provision of its services designed to cover its reasonable costs of operation and a corresponding schedule of discounts adjusted on the basis of the patient's ability to pay. Provided, that such schedule of discounts shall provide for a full discount to individuals and families with annual incomes at or below those set forth in the poverty guidelines updated periodically in the Federal Register by the U.S. Department of Health and Human Services under the authority of 42 U.S.C. 9902(2); and for no discount to individuals and families with annual incomes greater than twice those set forth in such Guidelines, except that nominal fees for services may be collected from individuals with annual incomes at or below such levels where imposition of such fees is consistent with project goals. Also, per 42 CFR 51c.303(g)(2) the community health center must make every reasonable effort, including the establishment of systems for eligibility determination, billing, and collection, to secure from patients payments for services in accordance with the schedule of fees and discounts required by paragraph 42 CFR 51c.303(f). Condition: During our testing of 25 encounters that received a sliding fee discount for health center patients qualifying for reduced charge visits we identified 2 encounters that did not comply with HealthPoint?s policy. The first noncompliant encounter received the incorrect sliding fee discount. The second noncompliant encounter received a sliding fee discount without having provided the required proof of income and household size information. Questioned Costs: None Context: This was identified during our testing of the Special Test Provision - Sliding Fee. Cause: Insufficient understanding of the policy and internal controls to ensure compliance. Effect: Potential that a patient would not receive the appropriate sliding fee discount. Recommendation: We recommend implementation of a second level independent review over the demographic data and income verification information entered into the patient billing system in order to ensure the financial classification is correct. Views of responsible officials and planned corrective actions: There is no disagreement with the audit finding. Management understands the significance of the issue raised. Management will implement monthly internal audits, continual trainings regarding the sliding fee discount program process, and verification of the information input into the practice management system.

GSA_MIGRATION