How to Speed up the FQHC Look-alike Application Process

FQHC Look-alike

It’s not clear when there will be any New Access Point (NAP) funding in the federal budget.  With the uncertainty of funding availability, another option for stabilizing your health clinic is to consider becoming a Federally Qualified Health Center (FQHC) Look-alike.

Becoming a FQHC Look-alike can take 12-15 months, but with expert assistance, Look-alike status may be granted in less time. One of the best ways to speed up the application process is to minimize the need to resubmit documents and other elements of the application by having an experienced consultant and health center grant writer develop a work plan that addresses the 19 program requirements and guides the health clinic through the process.

What is a FQHC Look-alike?

Health Center Program look-alikes operate and provide services just like a FQHC health center grantee but they do not receive federal operating funds. They are, however, eligible to apply to the Centers for Medicare and Medicaid Services (CMS) for reimbursement under FQHC Medicare and Medicaid payment methodologies. Medicaid payments to FQHCs and FQHC Look-alikes are calculated based on the cost of services provided and are therefore much higher than payments made to other practices. This higher level of reimbursement offers health centers greater financial stability and an incentive to apply for FQHC or FQHC Look-alike status.

Health Resources and Services Administration (HRSA) established look-alikes in order to increase access to care for medically underserved populations and communities. Both grant award recipients (FQHCs) and FQHC Look-alikes provide comprehensive primary health care services that serve the particular health care needs of their community, do not turn away patients based on inability to pay, and meet all health center program requirements.

All FQHC and FQHC Look-alikes gain the following benefits (FQHCs receive additional benefits):

  • Access to FQHC Prospective Payment System reimbursement methodologies for services provided to Medicare and Medicaid beneficiaries. The enhanced reimbursement for Medicare and Medicaid offers a Look-alike a path to financial stability.
  • 340B Federal Drug Pricing Program discounts for pharmaceuticals provide access to low-cost medications as well as a revenue stream.
  • Free vaccines for uninsured and underinsured children through the Vaccines for Children Program.
  • Help with recruiting and retaining primary health care providers through the National Health Service Corps.

What is the timeline for a FQHC Look-alike application?

The timeline for a FQHC Look-alike application is set by HRSA but times are approximate and may vary. Here is the basic timeline:

  1. Once the application is submitted, HRSA has 30 calendar days to complete a preliminary application completeness and eligibility (C&E) review.
  2. After the application passes the initial review, HRSA and the applicant have 60-90 days to schedule and prepare for a site visit. Applicants are asked to submit documents that illustrate compliance with all 19 program requirements.
  3. A HRSA team comes on site for a three day review.
  4. HRSA then has 60-75 days to complete an onsite compliance review with written report of any findings of non-compliance. They will also deliver the technical assistance tool that outlines the actions necessary to meet requirements.
  5. The applicant has 30 days to respond to additional information requested by HRSA and bring the program into full compliance.
  6. Finally, HRSA has 30-45 days to review the applicant’s response for additional information and issue notice of Look-alike designation or disapproval.

At each of these review periods, the goal should be to condense the timeline by greatly reducing the need to submit additional documentation. This is accomplished by submitting a complete and thorough application at the beginning of the process, which is much more likely with the help of a health center consultant.

How can a Health Center Solutions consultant speed up the FQHC Look-alike process?

At Health Center Solutions we are dedicated to helping community health centers. We can help your health center get organized to apply for FQHC Look-alike status so you can get on with providing health services to your target population with the benefits of FQHC Look-alike status. Our process starts with an assessment of your organization’s readiness to apply and then offers a road map to success. Our clients submit applications that are complete and correct, which reduces the timeline for approval. Health Center Solutions has a 100 percent success rate in getting Look-alike status for our clients. Many of our clients hire us to write their initial and renewal applications.

Health Center Solutions’ dedicated professionals are focused on providing outcome-focused, customer-driven solutions. To schedule a meeting or to request more information about our solutions, please contact us today!

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