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.