Federally qualified health center
A federally qualified health center (FQHC) is a reimbursement designation from the Centers for Medicare and Medicaid Services (CMS) of the United States Department of Health and Human Services (HHS). This designation is significant for several health programs funded under Section 330 of the Public Health Service Act, as part of the Health Center Consolidation Act. The FQHC program is designed "to enhance the provision of primary care services in underserved urban and rural communities."
FQHCs are community-based organizations that provide comprehensive primary and preventive care, including health, oral, and mental health services to persons of all ages, regardless of their ability to pay or health insurance status. Thus, they are a critical component of the health care safety net. As of 2011[update] over 1,100 FQHCs operate approximately 6,000 sites throughout the United States and territories, serving an estimated 20 million patients. That number is expected to go up to 40 million people by 2015 thanks to extra grant funding to the program.
FQHCs may also be referred to as community/migrant health centers (C/MHC), community health centers (CHC), and 330 funded clinics.
According to CMS, an entity may qualify as an FQHC if:
- it is receiving a grant under Section 330 of the Public Health Service (PHS) Act.
- it is receiving funding from a grant under a contract with the recipient of a grant, and it meets the Section 330 PHS Act requirements.
- it is not receiving a grant under Section 330 of the PHS Act but is determined by the HHS Secretary to meet the requirements for receiving such a grant based on Health Resources and Services Administration recommendations (noted as an "FQHC look-alike").
- the HHS Secretary, for purposes of Medicare Part B, treated it as a comprehensive Federally funded health center as of January 1, 1990.
- it is operating as an outpatient health program or facility of a tribe or tribal organization under the Indian Self-Determination Act.
- it is an urban Indian organization receiving funds under Title V of the Indian Health Care Improvement Act as of October 1, 1991.
An FQHC typically offers comprehensive primary care services, including:
- physician services, as well as associated services and supplies.
- nurse practitioner, physician assistant, certified nurse-midwife, clinical psychologist, and clinical social worker services, as well as associated services and supplies.
- visiting nurse services, primarily in specially designated shortage areas of home health agencies.
- drugs related to furnished FQHC services.
- outpatient diabetes self-management training and medical nutrition therapy for patients with diabetes or renal disease.
The FQHC will also offer Medicare-covered, supervised preventive care services such as:
- nutritional assessment and referral.
- children’s eye and ear examinations.
- voluntary family planning services.
- visual acuity and hearing screenings.
- cholesterol screening.
- tuberculosis testing for high-risk patients.
- prenatal and post-partum care.
- clinical breast examination.
- thyroid function tests.
On October 1, 1991, Section 1861(aa) of the Social Security Act (the Act) was officially amended by Section 4161 of the Omnibus Budget Reconciliation Act of 1990 to add Medicare coverage of certain FQHC services. The above services are likely to be Medicare-covered. Additional services may be offered by the FQHC but are not covered by Medicare. Likewise, other services like certain laboratory tests may be covered by Medicare but not offered at the FQHC itself.
A couple elements of this article are reused from the Wikipedia article.
- "Federally Qualified Health Center" (PDF). Rural Health Fact Sheet Series. Centers for Medicare and Medicaid Services. January 2013. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/fqhcfactsheet.pdf. Retrieved 30 March 2014.
- Doty, Michelle M.; Abrams, Melinda K.; Hernandez, Susan E.; Stremikis, Kristof; Beal, Anne C. (27 May 2010). "Enhancing the Capacity of Community Health Centers to Achieve High Performance: Findings from the 2009 Commonwealth Fund National Survey of Federally Qualified Health Centers". The Commonwealth Fund. http://www.commonwealthfund.org/Publications/Fund-Reports/2010/May/Enhancing-the-Capacity-of-Community-Health-Centers-to-Achieve-High-Performance.aspx?page=all. Retrieved 30 March 2014.
- "Number of Federally-Funded Federally Qualified Health Centers". Kaiser Family Foundation. March 2013. http://kff.org/other/state-indicator/total-fqhcs/. Retrieved 30 March 2014.
- Katz, Aaron; Felland, Laurie E.; Hill, Ian; Stark, Lucy B. (November 2011). "A Long and Winding Road: Federally Qualified Health Centers, Community Variation and Prospects Under Reform". HSC Research Brief No. 21. http://www.hschange.com/CONTENT/1257/?PRINT=1. Retrieved 30 March 2014.
- "Federally Qualified Health Centers (FQHC) Center". Centers for Medicare and Medicaid Services. http://www.cms.gov/Center/Provider-Type/Federally-Qualified-Health-Centers-FQHC-Center.html. Retrieved 30 March 2014.