EIN: 911537371
UEI: H96GWY8JUSA3
Audited by: Clark Nuber, PS
Oversight agency: 93 [Department of Health and Human Services]
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Data as of September 2, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on August 25, 2026. 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 February 25, 2027 (174 days from today).
What is a management decision? →Finding 2026-01 Significant deficiency in internal controls over compliance related to special tests and provisions. Federal Agency: Department of Health and Human Services Program Titles: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Award Numbers: 6 H80CS00702‐24‐02, 1 H8NCS54184‐01‐00, and 6 H80CS00702‐23‐04 Award Periods: April 1, 2024 through August 31, 2026 Criteria Internal controls requirements contained in Title 2 U.S. Code of Federal Regulations (CFR) 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance), Subpart D requires recipients of federal awards to adopt internal controls over compliance requirements that provide a reasonable assurance that compliance requirements are met. The Health Center Program Cluster requires that health centers prepare and apply a sliding fee discount schedule. Condition/Context for Evaluation The Organization does not have sufficient internal controls to ensure that the allowable and the applicable sliding fee discount schedule is applied. For six of forty sliding fee discounts selected for testing, the Organization billed patients inconsistent with their sliding fee discount schedule in effect at the time of the patient visit. The errors occurred after transition to a new sliding fee discount schedule and did not include charging fees in excess of a reasonable sliding fee discount schedule. Questioned Costs None noted. Cause The Organization has insufficient monitoring controls to ensure that a change in the slide fee scale is properly and consistently applied by the patient billing software. Effect Patients were charged fees inconsistent with the sliding fee discount schedule in effect at the time of service. Repeat Finding Not applicable. Recommendation We recommend that management develop a plan to monitor sliding scale fees applied on an ongoing basis, and that this plan include increased monitoring and sampling of the slides scale fees applied in the period after a change is implemented. Additionally, we recommend increased training for billers during a transition to a new sliding scale to ensure billers are able to identify errors. Views of Responsible Officials Management agrees that even though controls supported a mostly accurate implementation of the new sliding fee scale, controls did not catch and correct some cases where the old slide scale was incorrectly applied.
Show full finding ▾Hide full finding ▴Finding 2026-01 Significant deficiency in internal controls over compliance related to special tests and provisions. Federal Agency: Department of Health and Human Services Program Titles: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Award Numbers: 6 H80CS00702‐24‐02, 1 H8NCS54184‐01‐00, and 6 H80CS00702‐23‐04 Award Periods: April 1, 2024 through August 31, 2026 Criteria Internal controls requirements contained in Title 2 U.S. Code of Federal Regulations (CFR) 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance), Subpart D requires recipients of federal awards to adopt internal controls over compliance requirements that provide a reasonable assurance that compliance requirements are met. The Health Center Program Cluster requires that health centers prepare and apply a sliding fee discount schedule. Condition/Context for Evaluation The Organization does not have sufficient internal controls to ensure that the allowable and the applicable sliding fee discount schedule is applied. For six of forty sliding fee discounts selected for testing, the Organization billed patients inconsistent with their sliding fee discount schedule in effect at the time of the patient visit. The errors occurred after transition to a new sliding fee discount schedule and did not include charging fees in excess of a reasonable sliding fee discount schedule. Questioned Costs None noted. Cause The Organization has insufficient monitoring controls to ensure that a change in the slide fee scale is properly and consistently applied by the patient billing software. Effect Patients were charged fees inconsistent with the sliding fee discount schedule in effect at the time of service. Repeat Finding Not applicable. Recommendation We recommend that management develop a plan to monitor sliding scale fees applied on an ongoing basis, and that this plan include increased monitoring and sampling of the slides scale fees applied in the period after a change is implemented. Additionally, we recommend increased training for billers during a transition to a new sliding scale to ensure billers are able to identify errors. Views of Responsible Officials Management agrees that even though controls supported a mostly accurate implementation of the new sliding fee scale, controls did not catch and correct some cases where the old slide scale was incorrectly applied.
Corrective action planned: Management concurs with the finding and recognizes the importance of consistently applying the correct sliding fee discount schedule in effect at the time services are rendered. To address this finding, the organization has implemented enhanced monitoring and training controls over the application of the sliding fee discount schedules. The Director of Patient Services (or designee) will perform monthly audits of 25 randomly selected patients accounts that received a sliding fee discount to verify that the correct discount schedule was applied and that the patient responsibility was calculated accurately. In addition, for any future changes to the sliding fee discount schedule, management will implement a transition review process that includes: • Verification that the updated fee schedule is accurately loaded into the billing system prior to the effective date and old fee schedules are inactivated. • Additional training for billing staff before implementation of any revised sliding fee schedule. • Continued monthly audits of sliding fee discounted patient accounts. • Quarterly reporting of audit results to Chief Financial Officer, to identify recurring issues and ensure corrective actions taken are effective. Anticipated completion date: July 31, 2026
FAC accepted this audit on August 11, 2025 — management decision was due February 11, 2026.
FAC accepted this audit on August 19, 2024 — management decision was due February 19, 2025.
FAC accepted this audit on November 15, 2023 — management decision was due May 15, 2024.
FAC accepted this audit on October 19, 2022 — management decision was due April 19, 2023.
Finding 2022-001 Significant deficiency in internal controls over compliance and instances of noncompliance related to activities allowed and unallowed principles compliance requirement. Federal Agency: United States Department of Health and Human Services Program Title: HRSA COVID-19 Uninsured Program Federal Assistance Number: 93.461 Award Number: Not applicable Award Period: February 4, 2020 through April 5, 2022 Criteria Per the standards contained in Title 2 US Code of Federal Regulations Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards, Subpart D - Post Federal Award Requirements, Section 200.303, non-Federal entities are required to 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. The terms and conditions of the Federal award referenced require that if the recipient charged any uninsured individuals a fee relating to COVID-19 testing and/or testing related items, vaccine administration, care, or treatment for which the recipient subsequently received a payment from the uninsured program fund, the recipient was to communicate to the uninsured individuals that they do not owe for any portion of the services. If the uninsured individual paid the recipient for any portion of the services, the recipient was to return the payment in a timely manner. Condition/Context for Evaluation During testing for the year ended March 31, 2022, we noted that for four of the forty transactions selected, the Organization had collected payments from individuals in the amount of $274.75 and had not refunded the amounts in a timely manner. This was not a statistical sample. Effect or Potential Effect The Organization did not fully comply with the requirements specified in the terms and conditions of the Federal Award. Questioned Costs Not Applicable Cause The Organization?s internal controls did not ensure that if the uninsured individual paid for any portion of the services, that those payment were returned in a timely manner. Repeat Finding Not a repeat finding. Recommendation We recommend the Organization implement the necessary internal controls to ensure the terms and conditions of the Federal award are adhered to and that any refunds due to patients are processed timely. Views of Responsible Officials of Auditee Management agrees with the finding and has provided the accompanying corrective action plan.
Show full finding ▾Hide full finding ▴Finding 2022-001 Significant deficiency in internal controls over compliance and instances of noncompliance related to activities allowed and unallowed principles compliance requirement. Federal Agency: United States Department of Health and Human Services Program Title: HRSA COVID-19 Uninsured Program Federal Assistance Number: 93.461 Award Number: Not applicable Award Period: February 4, 2020 through April 5, 2022 Criteria Per the standards contained in Title 2 US Code of Federal Regulations Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards, Subpart D - Post Federal Award Requirements, Section 200.303, non-Federal entities are required to 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. The terms and conditions of the Federal award referenced require that if the recipient charged any uninsured individuals a fee relating to COVID-19 testing and/or testing related items, vaccine administration, care, or treatment for which the recipient subsequently received a payment from the uninsured program fund, the recipient was to communicate to the uninsured individuals that they do not owe for any portion of the services. If the uninsured individual paid the recipient for any portion of the services, the recipient was to return the payment in a timely manner. Condition/Context for Evaluation During testing for the year ended March 31, 2022, we noted that for four of the forty transactions selected, the Organization had collected payments from individuals in the amount of $274.75 and had not refunded the amounts in a timely manner. This was not a statistical sample. Effect or Potential Effect The Organization did not fully comply with the requirements specified in the terms and conditions of the Federal Award. Questioned Costs Not Applicable Cause The Organization?s internal controls did not ensure that if the uninsured individual paid for any portion of the services, that those payment were returned in a timely manner. Repeat Finding Not a repeat finding. Recommendation We recommend the Organization implement the necessary internal controls to ensure the terms and conditions of the Federal award are adhered to and that any refunds due to patients are processed timely. Views of Responsible Officials of Auditee Management agrees with the finding and has provided the accompanying corrective action plan.
Finding Number 2022-001: Contact Person: Amanda Barta, Chief Financial Officer abarta@mlchc.org Corrective Action Planned: Management concurs with the finding and understands the importance of refunding patient payments in a timely manner according to the requirements under the HRSA COVID-19 Uninsured Program. The Chief Financial Officer will ensure a policy and related procedures outlining the process for remitting timely refunds owed on claims with patient credits are implemented. The refunds owed to patients will be monitored by management monthly, to ensure accounts are worked and refunds are remitted to patients in a timely manner. Anticipated Completion Date: The policy and related procedures will be completed and implemented by November 30, 2022.
FAC accepted this audit on August 11, 2021 — management decision was due February 11, 2022.
FAC accepted this audit on August 6, 2020 — management decision was due February 6, 2021.
FAC accepted this audit on August 21, 2019 — management decision was due February 21, 2020.
FAC accepted this audit on August 22, 2018 — management decision was due February 22, 2019.
GSA_MIGRATION
Show full finding ▾Hide full finding ▴FAC accepted this audit on September 5, 2017 — management decision was due March 5, 2018.
GSA_MIGRATION
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GSA_MIGRATION
GSA_MIGRATION
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GSA_MIGRATION
FAC accepted this audit on September 27, 2016 — management decision was due March 27, 2017.
GSA_MIGRATION
Show full finding ▾Hide full finding ▴Data source: This information comes from the Federal Audit Clearinghouse, the official repository of Single Audit data. All data is public domain. Verify this organization's audit history at fac.gov.
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