Federally Qualified Health Centers (FQHCs) - Citations and

2825 - Federally Qualified Health Centers (FQHCs) - Citations and Description (Rev. 1, 05-21-04) 2825A - Citations (Rev. 40, Issued: 03-20-09, Effective: 03-20-09, Implementation: 03-20-09) Section 4161(a)(2) of OBRA ‘90 (P.L. 101-508) amended §1861(aa) of the Act and established FQHC services as a benefit under the Medicare program effective October 1, 1991. The statutory requirements that entities must meet to be considered an FQHC for Medicare purposes are at §1861(aa)(4) of the Act. Regulations establishing the FQHC benefit and outlining Conditions for Coverage for FQHCs were published on June 12, 1992, in the “Federal Register” (57 FR 24961) and became effective on the date of publication. These regulations were amended on April 3, 1996 (61 FR 14640). Section 13556 of OBRA 1993 (P.L. 103-66) amended §1861(aa) of the Act by adding outpatient health programs or facilities operated by a tribe or tribal organization under the Indian Self-Determination Act or by an urban Indian organization receiving funds under title V of the Indian Health Care Improvement Act, as entities eligible to participate in Medicare as FQHCs. 2825B - Description (Rev. 85, Issued: 07-19-13, Effective: 07-19-13, Implementation: 07-19-13) The Federally Qualified Health Centers (FQHCs) are considered “suppliers” under Part B of Medicare and are paid Part B benefits for FQHC services. For the purpose of Medicare enrollment, an FQHC is defined as an entity that has entered into an agreement with CMS to meet Medicare program requirements under 42 CFR 405.2434, and: • Is receiving a grant under Section 330 of the Public Health Service (PHS) Act; or • Is receiving funding under a contract with the recipient of a Section 330 grant, and meets the requirements to receive a grant under §330 of the PHS Act; or • Is an FQHC “Look-Alike,” i.e., the Health Resources and Services Administration (HRSA), has notified the facility it has been determined to meet the requirements for receiving a Section 330 grant, even though it is not actually receiving such a grant; or • Was treated by CMS as a comprehensive federally funded health center as of January 1, 1990; or • Is an outpatient health program or facility operated by a tribe or tribal organization under the Indian Self-Determination Act or by an Urban Indian organization receiving funds under title V of the Indian Health Care Improvement Act.