Hrsa Referral Agreements

Operating a successful Federally Qualified Health Centre (FQHC) requires an efficient structural organization. It also requires a thorough understanding of the treaties that are the framework of the FQHC. QQHCs can increase their efficiency and overall compliance by ensuring that they not only have the right contracts, but also use the most effective language in these contracts. This presentation will provide an overview of key requirements related to FQHC agreements, including benchmark agreements, professional services agreements and grant agreements, and will help maximize compliance and success. First, look at the 5A form you`ll find in the electronic manual.. Look at the formal intermediation contracts and agreements you have for services with other health facilities listed in Column II and Column III of Form 5A. Agreements between FQHCs and other health care providers are governed by federal fraud and abuse laws, including anti-kickback status. This may seem confusing, as federal law requires FQCs to maintain collaborative relationships and establish ongoing transfer links with hospitals to meet their grant obligations. While these requirements are a legitimate reason to continue these agreements, they do not apply to the federal prohibition on patient transfer compensation.

One of the fundamental attributes of FQHCs is that they provide services regardless of a patient`s ability to pay and charge the fees on the basis of a board-approved sliding fee scale. HRSA requires that a slippery pricing scale be available for both services provided directly by the health centre and services provided by formal written contracts or intermediation agreements with other providers. If you have marked a service in Column III, an agreement, MOA or formal agreement should at least describe how the transfer is carried out and managed and the process of referring patients to the Centre for appropriate follow-up. (As you review your written recommendation agreements, it`s not a bad idea to take a look at your follow-up and recommendation policies and procedures to make sure they reflect what you`re actually doing and what you`re describing in your agreements.) If your contractual or referral agreements have changed, do you need to change your scope? The basic rule is that QQC patients with annual incomes of less than 100% of federal poverty policies must benefit from an overall reduction (although a nominal fee is allowed) and a partial rebate for patients with annual incomes between 100% and 200% of federal poverty policies.

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