
Once Community Health Center funding has been awarded, CHCs are eligible for several benefits including:
- Access to additional federal grants, such as service expansion and medical capacity expansion grants.
- Access to grant support and loan guarantees for capital improvements.
- Access to Federal Tort Claims Act (FTCA) coverage in lieu of purchasing malpractice insurance for the CHC and its health care professionals, including certain contracted professionals providing services to health center patients within the approved scope of project and the professionals’ employment/contractor agreements.
- Access to favorable drug pricing under Section 340B of the PHS Act, which allows CHCs to purchase covered outpatient prescription pharmaceuticals for health center patients at substantially discounted prices for distribution either directly by a health center pharmacy or through contract with a retail pharmacy.
- Access to reimbursement under the Prospective Payment System (PPS) or other state-approved alternative payment methodology (which is predicated on a cost-based reimbursement methodology) for Medicaid services and cost-based reimbursement for services provided under Medicare.
- Absent an alternative approved by the Centers for Medicare and Medicaid Services (CMS), right to have State Medicaid agencies outstation Medicaid eligibility workers on CHC site.
- Reimbursement by Medicare for ‘first dollar’ of services rendered to Medicare beneficiaries, i.e., deductible is waived.
- Safe harbor under the federal anti-kickback statute for waiver of co-payments to the extent a patient is below 200% of federal income poverty guidelines and, therefore, entitled to a discount based on the health center’s application of its schedule of discounts.
- Access to providers through the National Health Service Corps if the health center’s service area is designated a Health Professional Shortage Area (HPSA).
- Access to the federal Vaccine for Children program, which distributes to CHCs and other eligible providers vaccinations at no charge for either the vaccine or its delivery to CHCs to be provided by the CHC to uninsured children. CHCs are also eligible to participate in the Pfizer Sharing the Care Program.