Effectively immediately, the Missouri Medicaid Audit and Compliance Unit (MMAC) is changing our policy regarding the enrollment of Federally Qualified Health Centers (FQHCs) and “FQHC look-alikes”. Previously, MMAC required FQHCs to be enrolled with Medicare before applying for enrollment with MO HealthNet. Recent analysis determined there is no federal or state requirement for a FQHC to be enrolled with Medicare and Missouri’s policy was not consistent with how other states are enrolling FQHCs in their Medicaid programs.
Effective immediately, a FQHC applying for enrollment with MO HealthNet must submit, from among the following, a copy of the current Notice of Grant Award from Public Health Services (PHS): 1) Section 329-Migrant Health Centers, 2) Section 330-Community Health Centers or 3) Section 340-Services to Homeless Individuals.
Non-federally funded health centers, which the Secretary of the Department of Health and Human Services has designated as a FQHC (“FQHC look-alikes”), must submit a copy of the letter from PHS designating the facility as an “FQHC look-alike” or as a non-federally funded health center.
Non-federally funded health centers that the Secretary of the Department of Health and Human Services determines may, for good cause, qualify through waivers of the PHS requirements, must submit a copy of the letter from PHS designating the facility as an “FQHC look-alike.” Waivers may be granted for up to two (2) years.
All other requirements for a provider applying for enrollment with MO HealthNet as a FQHC remain the same.
Any questions regarding this change of policy for the enrollment of FQHCs should be directed to the MMAC Provider Enrollment Unit at 573-751-3399 or MMAC.ProvderEnrollment@dss.mo.gov