Footnotes
1Here
and throughout the PIN, “section 330”
refers to section 330 of the Public
Health Service Act, as amended (42
U.S.C. 254b).
2PHS
Act section 330(a)(1)(A) and section
330(b)(1).
3PHS
Act section 330(a)(1)(B).
4
PHS Act section 330(b)(2).
5
See applicable section 330 program
regulations, 42 CFR Part 51c.107(c),
45 CFR Parts 74.25(c)(2), and DHHS
Grants Policy Statements. Requests
for changes in the scope of Federal
project should be submitted according
to the guidelines in PIN 2008-01,
“Defining Scope of Project and Policy
for Requesting Changes.”
6
For additional requirements regarding
changes in the Federal scope of project,
please see HRSA
PIN 2008-01, “Defining Scope of
Project and Policy for Requesting Changes”.
7
PHS Act section 330(a)(1)(A) and section
330(b)(1).
8
PHS Act section 330(b)(2).
9
To be eligible for payment at the FQHC
rate, the service must also be covered
as an ambulatory service in the state’s
Medicaid plan.
10
Inclusion in the Federal scope of project
is necessary but not sufficient to qualify
for these programs. For example, medical
malpractice coverage under the FTCA
also requires HRSA’s approval of a health
center’s FTCA deeming application.
As another example, a health center’s
Federal scope of project may include
a service that is not covered as an
“FQHC service” under the relevant State’s
Medicaid plan, consequently, that service
would be reimbursed at a fee-for-service
rate rather than a per visit rate.
11
Note that volunteer providers are not
covered under the FTCA for activities
at the health center.
12
For purposes of Medicaid and Medicare
FQHC reimbursement, a sub-recipient
is an organization that: (1) receives
funding from a section 330 grant through
a contract with the grantee and (2) is
compliant with all of the requirements
of section 330 of the PHS Act (see §1861(aa)(4)
and §1905(l)(2)(B) of the Social Security
Act). Requirements surrounding FTCA
coverage and FQHC reimbursement rates
set forth in past policy, statute, and
regulations continue to apply to sub-recipients
and sub-grantees.
13The
term “established arrangement” means
an arrangement where a service is provided
through a formal written contract or
cooperative arrangement (see section
330(a)(1) of the PHS Act).
14
Note the statutory requirement in section
330(k)(3) of the PHS Act that “primary
health services of the center will be
available and accessible in the catchment
area of the center promptly, as appropriate,
and in a manner which assures continuity.”
In addition, note the regulatory requirement
in 42 CFR 51c.303(m) that health centers
“must be operated in a manner calculated
... to maximize acceptability and effective
utilization of services.”
15
PHS Act section 330(a)(1)(B) and section
330(b)(2).
16
See section 330 program regulations,
42 CFR Part 51c.107(c), and 45 CFR Part
74.25.
17
For additional requirements regarding
changes in the Federal scope of project,
please see Attachment A of this PIN,
which lists the approval criteria for
prior approval of a Federal change in
scope request, as well as HRSA PIN 2008-01,
“Defining Scope of Project and Policy
for Requesting Changes.”
18
Section 330(h) Health Care for the Homeless
grantees are required to provide substance
abuse services. (Section 330(h)(2) of
the PHS Act.)
19
PHS Act Section 330(a)(1)(B).
20
In the latter case, both the service
and the site would need to be added
to the scope of project.
21
Section 330(k)(3)(G) of the PHS Act
and 42 CFR Part 51c.303(f).
22
See PIN
2002-22 for additional guidance
on the credentialing and privileging
of providers.
issued
December 18, 2008 |