Federally Qualified Health Centers (FQHCs) play an important role in healthcare. These facilities provide preventive and primary care to medically underserved low-income populations, offering an important safety net for more than 28 million people every year.
For 50 years, FQHCs have been trying to improve the lives of our nation’s urban and rural poor. Because these facilities receive funding from the federal government, they are held to strict compliance standards. Let’s review five FQHC regulations that are required and necessary to keep providing quality care to your patients.
FQHC Compliance – Follow These Rules
The government is heavily involved in reducing fraud and waste in FQHCs. As a result, several compliance areas govern this subset of healthcare delivery:
- Section 330 of the Public Health Service Act.
- Healthcare center program regulations.
- Various published interpretations of these rules, including Program Information Notices (PINs) and Program Assistance Letters (PALs).
- Additionally, there are often specific award conditions tied to the grant monies FQHCs receive.
To make things even more complex, FQHCs must also remain compliant with state and local laws and regulations. This could include rules from the health department related to the disposal of hazardous waste, for example. There are myriad compliance rules for these organizations to follow, from clinical and staff responsibilities to the security of patient health records, to the maintenance of their physical plant. Here are five examples of rules that govern FQHCs:
- First, each FQHC must have a separate agreement with Medicare for service reimbursement. If an FQHC operates in five distinct facilities, all five must be enrolled in Medicare. This does not apply to mobile units.
- Another rule is the FQHC must follow the Civil Rights Act of 1964 by not discriminating against a certain class of people.
- The FQHC is held to strict mission-based standards that require them to prove they are serving the needs of their target population. This is an important part of the grants application, monitoring, and renewal process.
- Too, the target population served and the services delivered must not overlap. There is actually a mapping tool that helps FQHCs follow this rule: https://www.udsmapper.org.
- Finally, how the organization is governed is a crucial part of the rules that each FQHC must follow. A board of directors must govern FQHCs with predefined rules for financial management, billing and even the composition of the board itself.
These are just a few of the stringent policies and guidelines that govern FQHCs. These rules are audited frequently for compliance by federal regulators. For an organization to continue their status as FQHC they must follow these guidelines, including any updates that occur.
In addition to receiving federal and state grant money as part of FQHC status, the benefits of following these rules include Medicaid and Medicare payment for services rendered, better pricing for medicines and insurance, and much more.
UHC Solutions and FQHCs
UHC Solutions is proud to work closely with the network of FQHCs around the country. For 20 years, UHC has provided these important healthcare providers with staffing solutions so they can continue their vital mission in the communities they serve. Contact us to find out more.