|
Federal Tort Claims Act Coverage
FTCA coverage is applicable only to staff and services that are documented as being within the scope of the approved project and included in provider employment agreements or contracts. Therefore, it is critically important that all requests for prior approval of changes in scope of project be submitted to HRSA and that the approved changes be included as part of the described scope of project in the health center's next application for Federal support in order to maintain FTCA coverage for these activities. Remember, although identification as a service site within a scope of project is necessary for participation in FTCA and other programs, each program has its own requirements that must be met.
Federally Qualified Health Center Medicaid Prospective Payment System or Alternative Methodology Reimbursement
After a change in scope of project is approved, it is the responsibility of each health center to notify its State Medicaid office of any changes pertaining to sites and services, if applicable. Most States rely on the approved scope of project to make Medicaid PPS or alternative payment methodology decisions.
Federally Qualified Health Center Medicare Cost-Based Reimbursement
After a change in scope of project is approved, it is the responsibility of each health center to notify its fiscal intermediary regarding any changes in service sites for the purposes of receiving FQHC Medicare reimbursement.
To be recognized by Medicare for FQHC reimbursement, a complete Centers for Medicare & Medicaid Services 855A Form and HRSA Notice of Grant award listing the address for the new site must be filed with the Appropriate Medicare Fiscal Intermediary for each new site.
Section 340B Drug Pricing Program
Health centers qualify as covered entities under the section 340B Drug Pricing Program. Identification as a service site within the scope of a project is necessary for participation in 340B. The HRSA Office of Pharmacy Affairs must be notified when changes in scope are approved.
Accreditation
Health centers accredited by an external accrediting body may be required to notify the accrediting body of changes in scope. Refer to the accrediting body's policies and procedures for complete information.
|
