Question 1

What are the 19 HRSA program requirements for FQHCs?

Accepted Answer

HRSA requires FQHCs to meet 19 program requirements covering: needs assessment, required/additional services, clinical staffing, accessible hours/locations, sliding fee scale, quality improvement/assurance, board authority, board composition, governance, financial management, billing/collections, budget, program data reporting, scope of project, federal/state requirements, health center controlled facilities, organizational structure, contracts/subawards, and conflict of interest policies. Noncompliance can result in conditions of award or loss of Section 330 funding.

Question 2

How often do FQHCs receive HRSA Operational Site Visits (OSV)?

Accepted Answer

FQHCs receive an Operational Site Visit from HRSA approximately every 3 years. The OSV reviews compliance with all 19 program requirements. FQHCs should maintain continuous readiness by conducting internal audits and keeping documentation current rather than scrambling before a scheduled visit.

Question 3

What are the HIPAA requirements for FQHCs?

Accepted Answer

FQHCs must comply with HIPAA Privacy, Security, and Breach Notification Rules including: Business Associate Agreements with all vendors handling PHI, annual security risk assessments (45 CFR § 164.308), workforce training within 30 days of hire and annually, breach notification to affected individuals within 60 days, and maintaining 6 years of HIPAA compliance documentation.

Question 4

Can FQHCs bill two encounters on the same day?

Accepted Answer

Under Medicare PPS, FQHCs can bill 2 encounters on the same day if the patient sees two different providers for two different services (e.g., medical + behavioral health). Under Medi-Cal, generally only 1 PPS encounter per day is allowed, though some managed care plans may allow exceptions. FQHCs cannot bill 'incident-to' like private practices.

Question 5

What is the False Claims Act penalty for FQHCs?

Accepted Answer

The Federal False Claims Act (31 USC § 3729-3733) imposes penalties of $13,946 to $27,894 per false claim plus treble damages (3× the overpayment). Common FQHC false claims include: billing incident-to, billing without face-to-face encounters, upcoding E/M levels, and 340B duplicate discounts. Whistleblowers receive 15-30% of recovered funds.

Centro de Comando de Cumplimiento de FQHCs

Visitas y Auditorías de HRSA

HIPAA y Privacidad del Paciente

Cumplimiento de Facturación y Fraude

Compensación de Trabajadores

Barreras Educativas

Herramientas Descargables

Lista de Verificación OSV de HRSA

Calendario de Cumplimiento 2026

Matriz de Evaluación de Riesgos

Próximas 30 Fechas Límite

Estudios de Caso Destacados

Acción Correctiva de Composición de la Junta

Violación de PHI por Correo Electrónico Sin Encriptar

Reclamos Falsos por Facturación Incident-to

Hallazgo de Auditoría de Farmacia Contratada 340B

Carrera en Cumplimiento

Recursos Adicionales

Inteligencia FQHC Semanal