The new policy, which applies to grantees and fqhc lookalike entities, clarifies various aspects of the sliding fee discount program sfdp, as. The purpose of this document is to highlight specific areas from the pin that have unique implications for special populations. The program serves as an important source of ongoing access to hiv medication that can enable people living with hiv to live close to normal lifespans. Fqhc by showing a commitment from the top and enforcing compliance standards throughout the entity. Scholarships and loan repayment for primary care providers who practice in areas with limited access to care. Chapter rural health clinic rhc and federally qualified health center fqhc services pdf see mm11019 pdf. If a health center experiences a decrease in its service population, it can lose some or all of. Site survey manual for use to submit calendar year 2010 nhsc site survey data.
They provide primary care services in underserved areas, provide care on a sliding fee scale based on ability to pay and operate under a governing board that includes patients. Eligibility federally qualified health centers are communitybased health care providers that receive funds from the hrsa health center program to provide primary care services in underserved areas. Mm10843 pdf cy 2019 payment rate update to the fqhc pps. They must meet a stringent set of requirements, including providing care on a sliding fee scale based on ability to pay and operating under a governing board. Stay uptodate on important developments in the fqhc arena and receive helpful resources and advice from s subject matter. Health center program compliance manual updated august 2018 pdf and website. Resources for conducting a fqhc needs assessement september 20. Behavioral health services are reimbursable when delivered in an office or outpatient setting only. Approved changes to the 2019 uds program assistance letter pal 2019 pdf 342 kb provides an overview of approved changes to the health resources and services administrations cy 2019 uds that is reported by health center program awardees and lookalikes by february 15, 2020. Hrsa need for assistance worksheet nfa required of all new access point applications accounts for 25% of nap application score fixed data sources fixed indicators and benchmarks 7 hrsa need for assistance worksheet nfa core barriers to care 3 of 4. Health center program compliance manual bureau of primary. Early intervention services and capacity development. Manual provides additional details regarding laboratories and. The compliance manual also addresses hrsa s approach to determining.
Due to planned maintenance, the ehbs will be unavailable on friday 06052020 8. According to the hrsa health center program requirements, program requirement 9 states, health center maintains a fully staffed health center management team as appropriate for the size and needs of the center. Pin 201402 clearly lays out the specifics that need to be in the sfd policy. Health centers are an important component of the national response to the covid19 pandemic. In february hrsa announced the integration of oral health and primary care practice initiative for safetynet settings.
How covid19 affects hrsa programs get information on how the coronavirus covid19 affects our programs. Health center program compliance manual introduction bureau. Pin 2014 02 clearly lays out the specifics that need to be in the sfd policy. The health resources and services administration hrsa bureau of primary health care bphc has revised the health center program compliance manual compliance manual, which. A practitioners guide to the npdb health resources and. Chapter 9 rural health clinics federally qualified health centers pdf. Review and understand requirements for health center hiring. Prior approval by hrsa of a change in the project directorexecutive directorceo position is required. Development and implementation of corporate compliance for fqhcs. Development and implementation of corporate compliance.
Out of network service payment issues have been resolved and any fqhc service provided must be paid at 100% of the july 1, 2016 apm pps rate. Effective january 1, 2016, acp is considered a facetoface service between a practitioner and a patient on advance directives and it is a standalone billable fqhc visit. Community health centers, or federally qualified health centers fqhcs, are nonprofit private or public entities that serve designated medically underserved populationsareas or special medically underserved. Use this link if you are a hrsa employee and you need to access your hrsa electronic handbooks ehbs. Part c of the ryan white hivaids program provides grant funding to local communitybased organizations to support outpatient ambulatory health service and support services through early intervention services eis program grants. Chapter 9 rural health clinicsfederally qualified health centers pdf medicare benefit policy internet only manual.
Federally qualified health centers provider manual chapter twenty. Federally qualified health centers fqhcs, known interchangeably as community health centers chcs, are required, as part of their hrsa 330 grant funding, to increase the number of consumers they serve each year, including highrisk older adults. Louis mercy clinic family medicine and obstetrics sullivan 1112622 yes. Loan repayment for individuals from a disadvantaged background who want to pursue a career as a faculty member in a health professions school. The bipartisan budget act of 2018 amended section 330 of the public health service act 42 u. The first component of the initiative was the development of a core set of oral health clinical competencies for primary care providers in safety net settings. Discusses centers for medicare and medicaid cms requirements for fqhcs and health resources and services administration hrsa bureau of primary health care requirements for health center program. Federal tort claims act health center policy manual. However, your local health center may not currently have covid19 testing capability e. Stay uptodate on important developments in the fqhc arena and receive helpful resources and advice from s subject matter experts, delivered to your inbox. In 2014, hrsa issued pin 201402, which clarified the rules surrounding this requirement. All policy and procedures are able to be fully customized to your organizations needs. Uniform data system uds resources bureau of primary. New governance pin 201401 to adequately evaluate the boards own effectiveness one must first fully understand the boards authority and responsibilities related to the hrsa health center program requirements in regard to the provision of primary care services to its targeted community with a special.
The compliance manual is the principal resource to assist health centers in understanding and demonstrating compliance with health center program requirements. Credentialing and privileging of healthcare practitioners hrsa program assistance letter pal 201202. We provide you with answers to the most frequently asked questions and concerns. Every two years the administrator is required to renew their organizations registration. The role of the board of directors at federally qualified. Federally qualified health center lookalikes are communitybased health care providers that meet the requirements of the hrsa health center program, but do not receive health center program funding. Using this link, you can also access the ftca federal tort claims act or fqhc federally qualified health center system. Provides an overview of federally qualified health centers fqhcs and health center program awardees and lookalikes, important safety net providers in rural areas. Federally qualified health centers are communitybased health care providers that receive funds from the hrsa health center program to provide primary care services in underserved areas. Also when a procedure is performed in a fqhc and the fee for service reimbursement is greater than the fqhc encounter rate, the cpt procedure code should be paid. Technical documentation for health resources service. This health center program compliance manual compliance manual applies to all health centers that apply for 1 or receive federal award funds under the health center program authorized by section 330 of the public health service phs act 42 u. They must meet a stringent set of requirements, including providing care on a sliding fee scale based on ability to pay and operating under a governing board that includes. Over the last 28 years, hrsas ryan white hivaids program has played a critical role in the united states public health response to hiv.
Clarification of credentialing and privileging policy outlined in pin 200116 hrsa pin 200116. About the ryan white hivaids program hivaids bureau. Detailed information regarding these changes will be. The health resources and services administration hrsa, u. Contact hrsa information center at 1888askhsra or download a pdf form from.
Federal tort claims act health center policy manual supersedes pin 201101 updated 721 2014. Structure of the health center program compliance manual. The new policy, which applies to grantees and fqhc lookalike entities, clarifies various aspects of. This application applies to federally qualified health centers fqhc that bill medicare on an institutional claim on a ub04 or its electronic equivalent and that wish to obtain a bcbsm facility code to enable payment for medicare supplemental services through crossover or via direct. Understanding hipaa hhs hipaa and mental health hhs 2014 340b drug program hrsa osha health care industry hrsa site visit protocol for hrsa health center program grantees and lookalikes. Hrsa data warehouse processing date mercy health st. Federal tort claims act health center policy manual hrsa. If an acp is rendered on the same day as the awv it is considered a preventive service and must be reported with modifier 33. Please ensure that you save your work and log off prior to the start of these activities to prevent unintentional loss of data. Calendar year 20 requirements for federal tort claims act ftca medical. Renewing the registration on time ensures that all user accounts have access to the npdb and can continue to query and report. Communication technology based services and payment for rural health clinic rhcs and federally qualified health centers fqhcs january 2019. The health resources and services administration hrsa is the principal federal agency charged with improving access to health care services for people who are medically underserved.
Federally qualified health centers fqhc center cms. Organizations will receive emails reminding them to renew their registration 60, 30, and 5 days before it expires. The statutory requirements that federally qualified health centers fqhcs must meet to qualify for medicare andor medicaid benefits are found in federal regulations 1861 aa4 of the social security act. A practitioners guide to the npdb textonly the national practitioner data bank is a webbased repository of reports containing information on medical malpractice payments and certain adverse actions related to health care practitioners, providers, and suppliers. Department of health and human services dhhs, provides national leadership in the development, distribution, and retention of a diverse, culturally competent health workforce that can adapt to the populations changing health care needs and provide the highestquality care for all. In 2014, hrsa issued pin 2014 02, which clarified the rules surrounding this requirement. Use this link if you are applying for, or have been awarded a hrsa grant and you need to access the hrsa electronic handbooks ehbs. Federally qualified health centers fqhcs and the health. Understand administrative and financial requirements. This is the ifth version of the f arizona rural health clinic designation manual the contents of this. Hrsa issues much anticipated sliding fee discount program. Help planrelated updates and others 08252015 rhc manual. Federally qualified health centers handbook developed by the childrens dental health project in recognition of the important role that contracting between private sector dentists and federally qualified health centers can play in ensuring that fqhc patients are provided costeffective, high quality oral health care services.
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