Health Center Program Compliance Frequently Asked Questions (FAQ)
Can’t find your answer here? Please submit your question through the BPHC Contact Form and select the appropriate issue type, or call Health Center Program Support at 1-877-464-4772.
The term “site visit” in these FAQ refers to:
- Operational Site Visits (OSVs) conducted for awardees
- OSVs conducted for look-alikes
- Initial Designation (ID) site visits conducted for look-alike applicants
The information in these FAQ only relates to requirements and processes of the HRSA Health Center Program.
Billing and collections
This question relates to Element a. Fee Schedule for In-Scope Services and Element b. Bases for Fee Schedule
Yes, if a health center provides "new patient visits" that involve a greater intensity of services based on locally prevailing rates and actual health center costs, then the health center may create a separate fee in its fee schedule for those types of visits. However, a health center cannot have sliding fee discount schedules that are different for new versus established health center patients because sliding fee discounts would be applied uniformly to all patients and would be based only on income and family size.
(Added: 3/8/2023)
This question relates to Element i. Billing for Supplies or Equipment
No, dentures and eyeglasses are related to, but NOT included in, services (for example, dental care or vision care) as part of prevailing standards of care for the service. Therefore, these supplies are NOT subject to the Health Center Program sliding fee discount program requirements. In making dentures, eyeglasses, and other supplies accessible to their patient population, a health center determines how to charge its patients (for example, flat discounts, at cost, sliding fee discounts, bundled as part of a service). The health center would inform patients of any out-of-pocket charges prior to the time of service.
There are supplies and equipment (for example, casting materials, bandages), that ARE included in a service as part of prevailing standards of care and that do not have a separate charge on the health center's fee schedule. Therefore, the service as a whole, including the supplies and equipment, is discounted in accordance with the health center's sliding fee discount program.
For more information, refer to the Health Center Program Compliance Manual Chapter 9: Sliding Fee Discount Program and the Health Center Program Compliance Manual Chapter 16: Billing and Collections.
(Added: 3/8/2023)
This question relates to Element i. Billing for Supplies or Equipment
No, prescription drugs are supplies that are related to, but NOT included in, the service itself as part of prevailing standards of care for the service. Therefore, prescription drugs are NOT subject to the Health Center Program sliding fee discount program requirements. In making prescription drugs accessible to their patient population, a health center determines how to charge its patients (for example, flat discounts, at cost, sliding fee discounts, bundled as part of a service). The health center would inform patients of any out-of-pocket charges prior to the time of service.
All health centers are required to provide pharmaceutical services, which are separate from prescription drugs.
For more information, refer to the Health Center Program Compliance Manual Chapter 9: Sliding Fee Discount Program, the Health Center Program Compliance Manual Chapter 16: Billing and Collections, and the Service Descriptors for Form 5A: Services Provided (PDF - 315 KB).
(Added: 3/8/2023)