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HRSA’s Division of Financial Integrity (DFI) has issued and implemented a tool that it uses to review health centers and other HRSA grantees. The tool has 18 “Management Control Areas” including cash management, internal controls, time and effort, and conflicts of interest, to name a few. Importantly, while these Management Control Areas overlap with the grants management chapters of HRSA’s Compliance Manual for Health Centers, they also differ in substance and in detail. While not every health center will receive a DFI financial review, every health center should understand what DFI is reviewing and why.