Federally Qualified Health Center (FQHC) Start-Up FAQ
Federally Qualified Health Center FAQ
1. What is a Federally Qualified Health Center (FQHC)?
An Federally Qualified Health Center (FQHC) is a community-based healthcare provider that offers primary care services in underserved areas, regardless of patients’ ability to pay. FQHCs qualify for federal funding under Section 330 of the Public Health Service Act and receive enhanced reimbursements from Medicare and Medicaid, access to 340B drug pricing, FTCA malpractice coverage, and eligibility to recruit providers through the National Health Service Corps (NHSC).
2. What are the benefits of becoming an FQHC?
Becoming an FQHC provides numerous advantages, including:
- Enhanced Medicare/Medicaid reimbursement (PPS methodology)
- Access to federal grants through HRSA
- Eligibility for the 340B drug pricing program
- Malpractice coverage under FTCA
- Loan repayment/recruitment support via NHSC
- Expanded services and community impact
3. What are the basic eligibility criteria for FQHC status?
To qualify as an FQHC or FQHC Look-Alike, your organization must:
- Serve a Medically Underserved Area (MUA) or Population (MUP)
- Provide services on a sliding fee scale
- Offer comprehensive primary care services
- Operate under a community-based governing board (51% must be patients)
- Be a non-profit or public entity
4. What’s the difference between an FQHC and an FQHC Look-Alike?
- FQHC: Receives Section 330 grant funding and all associated benefits.
- FQHC Look-Alike: Meets all program requirements but does not receive the 330 grant; still qualifies for enhanced reimbursements, FTCA, and 340B pricing.
5. How long does it take to set up an FQHC?
The timeline varies, but typically:
- Feasibility study & planning: 3–6 months
- Legal formation & board setup: 1–2 months
- Facility preparation & hiring: 3–6 months
- HRSA grant application & review: 6–12 months The entire process may take 12–24 months from planning to operational launch.
6. What services do you provide for FQHC start-ups?
Our end-to-end FQHC start-up services include:
- HRSA 330 or look-a like application support
- Sliding fee scale and policy development
- EHR implementation and billing setup
- Provider credentialing and payer enrollment
- Quality, risk, and compliance policies
- Marketing, outreach, and referral network setup
7. What are the key documents needed for an FQHC application?
A comprehensive FQHC application includes:
- Business plan & financial projections
- Community needs assessment
- Sliding Fee Discount Program policy
- Credentialing and quality assurance plans
- Staffing model and org chart
- Bylaws and Articles of Incorporation
- Governing board meeting minutes
- Facility and service readiness documents
8. Can we start with an FQHC Look-Alike before applying for the 330 grant?
Yes. Many organizations start as look-a likes to build capacity and operational maturity before applying for HRSA grant funding. TriumpHealth help prepare your clinic to meet all compliance benchmarks before full FQHC designation.
9. What geographic areas are eligible to host an FQHC?
You must be located in or serve:
- A Medically Underserved Area (MUA) or
- A Medically Underserved Population (MUP) We assist in evaluating your service area eligibility using HRSA’s online tools and provide documentation support for new designation requests if needed.
10. Do you provide post-launch support?
Yes, we offer ongoing support services including:
- Billing optimization and revenue cycle consulting
- MIPS and quality improvement strategy
- Credentialing and revalidation services
- Compliance audits and risk management
11. What TriumpHealth makes your FQHC consulting services unique?
TriumpHealth combines healthcare regulatory expertise, deep payer knowledge, and hands-on implementation support. With experience across 300+ healthcare providers and multiple FQHC’s, our team delivers scalable, compliant, and sustainable start-up frameworks tailored to your mission and community needs. To learn more about how we can set up your FQHC, contact us today at (888)-747-3836 X0 or email us at [email protected]
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