In order for a Community Health Center to become a FQHC Look-alike, the organization must first apply for and be designated nonprofit 501(c)(3) status by the Internal Revenue Service (IRS). This is not a requirement of the Bureau of Primary Health Care; it is a Medicare requirement. In order to complete an application for Medicare reimbursements, Medicare mandates all nonprofit organizations show proof of 501(c)(3) status.
A FQHC (Federally Qualified Health Center) Look-alike is a health center that meets all Health Center Program requirements and is part of the Health Center Program but does not receive federal award funding. Having Look-alike status does provide several important benefits, however, including access to FQHC Prospective Payment System reimbursement methodologies for services provided to Medicare and Medicaid beneficiaries and discounts on pharmaceutical drugs through the 340B Federal Drug Pricing Program.
Federal grants to support new health centers have been available every other year since President George W. Bush set a goal to create 10,000 new health centers in 2005. The Obama Administration continued funding “New Access Points” with stimulus funds and the Affordable Care Act. With uncertainty around federal funding priorities under the Trump Administration, your clinic might want to consider becoming a community health center under the Federally Qualified Health Center (FQHC) Look-alike program.