Federally Qualified Health Centers
Federally Qualified Health Centers (FQHCs) are facilities that are primarily engaged in providing services that are typically furnished in an outpatient clinic and are a critical component of the health care safety net. FQHCs were established in 1990 by section 4161 of the Omnibus Budget Reconciliation Act of 1990 and were effective beginning on October 1, 1991.
Benefits of Being an FQHC
There are many benefits of being a FQHC including:
- 330 Grant funding (up to $650,000 in new start money)
- Receive reimbursement under the Prospective Payment System (PPS) for service provided under Medicare
- Receive reimbursement under the Prospective Payment System (PPS) or other State-approved Alternative Payment Methodology (APM) for service provided under Medicaid
- Medical malpractice coverage for the organization, its employees, and eligible contractors through the Federal Tort Claims Act
- Eligibility to purchase prescription and non-prescription medications for outpatients at reduced cost through the 340B Drug Pricing Program
- Access to National Health Service Corps
- Designated as an Automatic Facility HPSA
- Access to the Vaccines for Children Program
- Eligibility for various other federal grants and programs
Eligibility
To be certified as an FQHC, an entity must meet one of the following requirements:
- Be a Health Resources and Services Administration (HRSA) Health Center Program Grantee: Organizations receiving grants under section 330 of the PHS Act, including Community Health Centers, Migrant Health Centers, Health Care for the Homeless Health Centers, and Public Housing Primary Care Centers
- Be a Health Center Program Look-Alike: Organizations that have been identified by HRSA as meeting the definition of “Health Center” under section 330 of the PHS Act, but do not receive grant funding under section 330
- Be an outpatient health program/facility operated by a tribe or tribal organization (under the Indian Self-Determination Act) or by an Urban Indian Organization (under Title V of the Indian Health Care Improvement Act)
Additionally, a FQHC or FQHC look-Alike must:
- Provide comprehensive services (either on-site or by arrangement with another provider) including:
- Preventative health services
- Dental services
- Mental health and substance abuse services
- Transportation services necessary for adequate patient care
- Hospital and specialty care
- Have an ongoing Quality Improvement/Assurance Plan that includes clinical services and management, and maintains the confidentiality of patient records
- Have a governing board of directors
- Be a nonprofit or public organization
- Offer services to all persons, regardless of a person’s ability to pay
- Offer a sliding fee scale to persons with incomes below 200 percent of the federal poverty level
- Serve in a designated medically-underserved area (MUA) or medically-underserved population (MUP)
- Not be concurrently approved as a Rural Health Clinic
How to Become an FQHC
Eligible public and non-profit private entities can become part of the HRSA Health Center Program in two ways:
- A successful application for Health Center Program funding.
- A successful application for look-alike designation.
Organizations must apply for Health Center Program grant funding by submitting an application in response to a competitive open funding opportunity announcement by HRSA.
- New Access Point (NAP) funding provides operational support for new health care service delivery sites (i.e., new access points) that will deliver comprehensive, culturally competent, quality primary health care services. Applicants must propose at least one full-time, permanent new access point site whose main purpose is primary medical care. Applications may be submitted from organizations that do not currently receive Health Center Program funding or from existing Health Center Program award recipients to expand their network of service delivery sites to new underserved populations and service areas. NAP funding is based on Congressional appropriation, therefore it may not be available every year. For information about the most recent NAP funding opportunity, see BPHC Funding Opportunities.
- Service Area Competition (SAC) funding ensures continued access to comprehensive, culturally competent, quality primary health care services for communities and vulnerable populations currently served by the Health Center Program. Applications may be submitted by organizations that currently serve or propose to serve an announced service area and its associated populations. Only one award is funded for each announced service area. For information about the most recent SAC funding opportunities, see BPHC Funding Opportunities.
How to Become an FQHC Look-a-Like
Organizations that are eligible to apply for FQHC look-alike status meet all FQHC requirements but do not receive funding under section 330 of the PHS Act.
Organizations can create their application in the HRSA Electronic Handbook (EHB) anytime (rolling deadline). View instructions on how to submit look-alike applications in the EHB.
| Federal Support for FQHC and FQHC Look-A-Like Designation | FQHC | Look-a-Like |
|---|---|---|
| Receive Health Center Program federal grant funding under the Section 330 Public Health Service Act | Yes | No |
| Eligible for malpractice coverage under the Federal Tort Claims Act | Yes | No |
| Eligible for federal loan guarantees for capital improvements | Yes | No |
| Receive 340B Federal Drug Pricing Program discounts for pharmaceutical medications | Yes | Yes |
| Eligible for enhanced Medicaid/Medicare reimbursement | Yes | Yes |
| Automatic designation as a Health Professional Shortage Area (HPSA) facility which provides eligibility to apply and receive National Health Service Corps (NHSC) personnel and eligibility to be a site where a Conrad J-1 Visa Waiver physician can serve | Yes | Yes |