Review cadence
- Source date
- 2026-07-16
- Claim review
- 2026-07-16 · 22/22
- Proven sweep
- 2026-07-16
- Target
- TT · monthly
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Federated States of Micronesia has 4 community health centers across 16 sites serving 11,397 patients — the #54 FQHC state by patients in the national-breadth layer. Its community health centers depend on the federal Community Health Center Fund, authorized only through December 2026.
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We keep source date, claim review, and a completed source sweep separate. None of these clocks substitutes for another.
4,760 reported patients
Actual values: 7/12 · source-backed: 7/12
Visible gaps: EHR, career source, history, reported financials, NPPES operator identity.
Hash-pinned review: 2026-07-19 · next 2027-01-15
This public log starts July 14, 2026. Zero logged changes does not mean a page or claim never changed before that date.
2026-07-16 · material correction
Corrected this FM record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this FM record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this FM record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this FM record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this FM record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this FM record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this FM record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · addition
New tracked FM development added to the state intelligence feed.
2026-07-16 · addition
New tracked FM development added to the state intelligence feed.
2026-07-16 · addition
New tracked FM development added to the state intelligence feed.
2026-07-16 · addition
New tracked FM development added to the state intelligence feed.
2026-07-16 · material correction
Corrected this FM record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · addition
New tracked FM development added to the state intelligence feed.
2026-07-16 · material correction
Corrected this FM record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this FM record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this FM record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · addition
New tracked FM development added to the state intelligence feed.
2026-07-16 · addition
New tracked FM development added to the state intelligence feed.
2026-07-16 · addition
New tracked FM development added to the state intelligence feed.
2026-07-16 · addition
New tracked FM development added to the state intelligence feed.
2026-07-16 · material correction
Corrected this FM record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · addition
New tracked FM development added to the state intelligence feed.
2026-07-15 · addition
New tracked FM development added to the state intelligence feed.
2026-07-15 · addition
New tracked FM development added to the state intelligence feed.
2026-07-15 · addition
New tracked FM development added to the state intelligence feed.
2026-07-15 · addition
New tracked FM development added to the state intelligence feed.
2026-07-15 · addition
New tracked FM development added to the state intelligence feed.
Send a correction or new source to improve this state page.
The Federated States of Micronesia (FSM) is a sovereign country in free association with the United States, not a U.S. state or territory, and it does not operate a U.S. Medicaid program on-island. HRSA's 2024 Uniform Data System aggregates four reporting Health Center Program awardees in FSM: 19,791 patients, including 14,000 reported as uninsured and zero reported as Medicaid/CHIP patients. HRSA's FY2025 fact sheet records $3,736,022 for four Health Center Program awardees. Separately, GAO reports that the United States made $140 million in Compact sector grants available to FSM for FY2025 and is committed to that annual amount through FY2043; FSM's FY2025 plan proposed $33,618,258 for health, while delayed reporting, construction constraints and late Compact implementation complicate execution. For eligible FSM citizens lawfully residing in the United States under COFA, Medicaid is a host-jurisdiction issue: section 71109 of Public Law 119-21 retains COFA migrants in the federal-funding eligibility categories beginning October 1, 2026, but all other program requirements still apply and territorial coverage remains optional.
Patient-weighted across the 3 centers with UDS 2024 data.
A U.S. state-style nurse-practitioner scope classification is not applicable to FSM because it is a sovereign freely associated country, not a U.S. licensing jurisdiction. This review did not independently establish a single nationwide FSM rule for advanced-practice nursing or resolve state-level credentialing differences within FSM. When an FSM citizen receives care in a U.S. state or territory, the host jurisdiction's licensing and scope rules govern; no one U.S. jurisdiction's rule should be generalized to all COFA patients.
As a Freely Associated State, Federated States of Micronesia health centers rely on federal Compact and HRSA Section 330 funding rather than Medicaid; the headline risk is the stability of federal grant appropriations and Compact funding, not Medicaid work requirements.
Jurisdiction operating analog
This framework does not force territorial Medicaid or Compact assistance into state-only fields. Every lane preserves its own authority and source.
FSM is a sovereign freely associated state, not a U.S. territory with an on-island section 1108 Medicaid program. Its U.S. health financing analog is Compact economic and sector assistance—part of a $3.3 billion, 20-year package through 2043—combined with FSM's own public financing and other grants.
U.S. Department of the Interiorreviewed 2026-07-14GAO's May 2026 review found that FSM, RMI, and Palau prioritize education and health in FY2025 Compact allocations, while delayed disbursements, higher construction costs, labor shortages, and late oversight documents slow implementation. FSM planning should track cash availability and execution milestones rather than treat the authorized Compact total as cash on hand.
U.S. Government Accountability Officereviewed 2026-07-14FSM's Department of Health and Social Affairs maintains its own nurse-licensing and medical-licensing functions. On-island workforce analysis must use FSM authority; for an FSM citizen working in a U.S. FQHC, the governing credential is instead the license of the U.S. state or territory where that clinician practices.
FSM Department of Health and Social Affairsreviewed 2026-07-14Only basic care is available on FSM's main islands, and medical evacuation is by air, can take days, and is expensive; Chuuk, Yap, and Kosrae do not have daily commercial flights. Referral planning must therefore record flight availability, stabilization capacity, receiving acceptance, and financing instead of assuming a mainland-style transfer network.
U.S. Department of Statereviewed 2026-07-14FSM's Office of Personnel published a Public Health Nurse opening for Chuuk with duties in remote dispensaries and state facilities, an open-until-filled status, and an employer salary range. Preserve that primary posting and its date; if it closes or the board is unreachable, current demand becomes unknown rather than zero.
FSM National Government, Office of Personnelreviewed 2026-07-14FSM cannot receive a direct RHTP award because CMS limits eligible applicants to the 50 U.S. states and excludes every other entity. Record RHTP as ineligible/not applicable and keep Compact assistance in its own financing lane; the two programs are not interchangeable.
Centers for Medicare & Medicaid Servicesreviewed 2026-07-14Role implications
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Federated States of Micronesia ranks #54 by FQHC patients, with 4 organizations and 16 sites tied to federal grant exposure.
Use this as the board agenda frame: exposure, owner, decision date, and the first source to recheck.
0% Medicaid/CHIP, 81.7% uninsured, and uninsured share is 81.7%.
Turn the payer mix into scenarios for PPS, 340B, grants, and patient-volume stress.
HRSA organization data while public job-source coverage expands; largest systems and directory links show where hiring capacity may need verification.
Use the state read to pick roles to watch, openings to save, and retention risks to discuss with managers.
Federated States of Micronesia combines 11,397 FQHC patients with scope-of-practice NP practice context and access pressure from payer mix.
Map the signal to panel access, team-based care, top-of-license planning, and patient-impact follow-up.
PIPCA, state policy context, and the December 31, 2026 CHC Fund cliff define the sources to keep current.
Assign one source owner for state policy, one for federal deadlines, and one for billing/audit implications.
Federated States of Micronesia has 4 FQHC employers in the directory and HRSA organization data while public job-source coverage expands to compare before applying.
Use the state context to choose target employers, tailor proof, and save the next job or resource in My Progress.
Browse FQHC jobs in Federated States of Micronesia and nationwide.
The observation remains unknown until a reproducible source sweep or manual review is completed. No published match does not mean zero layoffs.
The row count describes the official artifact, not a count of FQHC layoffs.
22 primary-sourced findings on Federated States of Micronesia FQHC policy and financing.Newest item: 2026-07-16
The State Department country-information page, reviewed July 16, 2026, says only basic medical care is available on FSM's main islands; each of the four major islands has a state-run hospital, Pohnpei has one private hospital, and scattered clinics provide additional care. It says medical evacuation is available only by air, may take days and is expensive; public clinics lack basic resources and supplies, and mental-health services are extremely limited.
This is current operating context, not a dated policy change or a quantified referral flow to U.S. providers.
HHS TAGGS lists three FY2026 actions under Substance Abuse Prevention, Treatment, and Recovery Services Block Grant B08TI088477 for the FSM Department of Health and Social Affairs: $195,960 on January 28, $197,501 on May 27 and $396,544 on July 10, 2026, for a $790,005 subtotal. The award record does not identify a clinic-level distribution, staffing increment or patient count.
This current total includes the July action that was absent from an earlier indexed snapshot.
The FSM Department of Health and Social Affairs reported that its June 22–23 workshop in Palikir reviewed the department's zero-tolerance sexual-harassment policy, a confidential step-by-step reporting framework, anti-retaliation protections, and Sexual Harassment Contact Officer roles. Participants developed 90-day team action plans that called for 100% mandatory-training completion, more visible support resources, and recurring respectful-workplace discussions.
The 100% figure is a target, not a reported completion rate; the source gives no participant or workforce denominator, policy effective date or text, complaint or enforcement count, retention result, or measured service or patient outcome.
The FSM Department of Health and Social Affairs reported that the June 8–11 annual MCH meeting in Kosrae brought together program representatives from Yap, Chuuk, Pohnpei, and Kosrae plus national staff and partners. Participants completed and reviewed each state's 2025 progress report, validated the FSM MCH Data Matrix, refined state action plans for the coming fiscal year, and completed final validation of the MCH Manual.
The manual was still in final review and preparation for official release and implementation; the source reports no release date, site-level adoption, staffing or capacity change, spending amount, service volume, or measured patient outcome.
CMS's June 2026 implementation deck states that Public Law 119-21 limits federal Medicaid and CHIP payment beginning October 1, 2026 but retains individuals lawfully residing in the United States under COFA among the listed eligible categories. The deck also says section 71109 did not change the existing territorial option to cover COFA migrants.
Retention in the federal-funding category is not automatic enrollment: income, residency and other host-program eligibility rules still apply, and separate CHIP treatment has additional rules.
Pacific Air Forces’ conclusion story says Pacific Angel 26-3 operated April 24–May 3, 2026 in Pohnpei, Kosrae, Chuuk and Yap, offering medical services, subject-matter exchanges and health outreach. It reports that the larger Chuuk footprint delivered physical therapy, eye care, dental care and public-health services to more than 400 patients; teams also delivered school health education and disease-prevention presentations at Chuuk State Hospital, and two C-130Js moved supplies and personnel among states.
The source publishes no patient count for Pohnpei, Kosrae or Yap, does not say whether the Chuuk count is unique patients, and provides no procedure mix, local staffing or FTE change, ongoing schedule, cost, follow-up, or outcomes. This was a temporary multinational exercise, not permanent state capacity or evidence of U.S. Health Center Program or FQHC delivery.
WHO reported on May 21, 2026 that its staff worked with Chuuk State Department of Health Services after Super Typhoon Sinlaku to assess facilities and provide catch-up immunization, diagnosis, treatment, referrals, medicines and supplies in affected communities. A Chuuk immunization nurse reported visiting more than 12 villages and serving more than 300 community members during the prior three weeks; the source also documents the destroyed Polle Sapou dispensary and an over-one-hour boat referral to the main hospital.
The figures are staff-reported operational counts, not audited unique-patient totals, and the emergency response does not establish restored permanent capacity, staffing, outcomes or Health Center Program delivery.
GAO's table of FSM's FY2025 Annual Implementation Plan lists $33,618,258 for health and a separate $35 million public-infrastructure allocation. GAO says the infrastructure category was intended for new construction and maintenance in health and education, including schools and medical dispensaries, among other purposes.
The full $35 million therefore must not be counted as health funding, and the table reports proposed allocations rather than final outlays.
GAO records FSM's proposed FY2025 health-sector allocation as $33,618,258, about 24% of the $140 million sector-grant total; most health and education funding supported salaries and wages. As of December 30, 2025, FSM had submitted five of six selected FY2025 documents other than the single audit, but only two were on time.
Its FY2023 single-audit report was submitted 547 days late, and its FY2024 audit remained 183 days overdue. The figures describe proposals and reporting status, not verified health-sector expenditures or patient outcomes.
GAO reports that FSM's population fell from 102,843 in the 2010 census to 75,817 in the 2023 census, a 26% decline. Officials told GAO that migration for health services, education and employment contributed to the loss and aggravated skilled-labor shortages.
GAO also documents delayed FY2024 Compact disbursement after the March 2024 implementing legislation, higher construction and shipping costs, limited bidders, complex land systems and imported-labor costs. These are documented national health-system and project-delivery constraints; the report does not quantify how many migrants use U.S. health centers.
The College of Micronesia-FSM's 2025–2026 General Catalog lists a 47-credit Certificate of Achievement in Community Health Sciences—Health Assistant Training Program as available only at its Yap and Pohnpei campuses. The curriculum covers adult and child health, maternal and child health, communicable and noncommunicable disease, behavioral and dental health, nutrition, first aid, environmental health and dispensary management; admission ordinarily requires one year of undergraduate study, while candidates with sufficient academic achievement and two years of practical health-related experience may also be considered.
The catalog establishes the listed curriculum and campuses, not current course sections, enrollment, graduates, faculty or FTE, licensure, employment placement, facility staffing, service volume or outcomes; it does not establish FQHC, IHS, U.S. federal accreditation or authority, or Compact funding.
HHS TAGGS lists three FY2026 actions under award B0455428 for the FSM Department of Health and Social Affairs: $180,788 on December 3, 2025, $44,823 on March 10, 2026 and $186,074 on April 15, 2026. TAGGS reports a $411,685 FY2026 subtotal and a performance period from October 1, 2025 through September 30, 2027.
This corrects an earlier total that omitted the March action; TAGGS does not by itself identify the clinics, patients or activities receiving each dollar.
HHS TAGGS lists a $347,862 action dated March 31, 2026 under award FPHPA006546 to the FSM Department of Health and Social Affairs. The award title is 'Creating Equity by Improving Service Quality and Reach of Family Planning Services in the Federated States of Micronesia.'
This current award record supersedes reliance on a stale directory; it does not by itself establish how funds are divided among Chuuk, Kosrae, Pohnpei and Yap or which service sites receive them.
WHO reports that its November 24–28, 2025 visit marked the change from a Country Liaison Office to a multi-country WHO Representative Office serving FSM, the Marshall Islands and Palau, led by Dr. Roderico Ofrin. At Pohnpei State Hospital, discussions covered primary health care, infrastructure, digital health and workforce capacity; WHO specifically reported concern that the current generation of doctors, nurses and other health workers is approaching retirement and that FSM urgently needs to replenish human resources for health.
The article identifies priorities, not a funded staffing target or vacancy count.
HRSA’s current FY2026 Application/FY2024 Annual Report narrative says health-service delivery is the responsibility of each state Department of Health Services and that primary-care facilities are not integrated and vary in capacity and resources. It describes Chuuk building state-run maritime super-dispensaries; Kosrae and Yap using non-state CHC models on their main islands while Yap’s outer islands use state dispensaries; and Pohnpei consolidating a mobile-team model that expands dispensary services on selected days depending on location.
It says multi-program outreach is operational in all four states, but limited community profiling and weak mobilization reduce effectiveness in some places. This is an FSM-grantee-reported structural and planning narrative published in the December 2025 Title V package; it does not verify that every described facility or schedule was active at review, give site counts, staffing or FTE, visits, travel reduction, costs, or outcomes.
The source’s “CHC” terminology is not treated as proof of U.S. FQHC equivalence.
The Commonwealth Fund explains that Public Law 119-21 retains COFA migrants in the narrowed Medicaid, Marketplace-subsidy and Medicare immigration categories while excluding several other lawfully present groups on different implementation dates. It cites projections that more than 1 million lawfully present immigrants will lose Medicaid, Medicare or Marketplace coverage beginning in 2026.
That estimate is national and is not a count of FSM citizens, COFA patients, health-center patients or observed losses; the FSM-specific point is the retained COFA category.
The FSM Department of Health and Social Affairs reported that FSM and the World Health Organization held a five-day national workshop from September 15 through 19, 2025: three days to develop a national emergency risk profile, one day to map and strengthen the emergency surge workforce, and one day to train national facilitators.
More than 25 participants from health, disaster management, logistics, security and other agencies used the STAR methodology and a One Health approach. The source documents completed training and workforce analysis, not adoption of a national emergency plan, a deployable roster or headcount, hiring, response deployment, facility capacity, services, spending or outcomes; it does not identify a health-center operator or establish FQHC, IHS, U.S. federal or Compact-funded activity.
During FSM's September 1–5, 2025 digital-health conference in Yap, the FSM Department of Health and Social Affairs handed five Starlink units to Yap's Director of Health Services for dispensaries that already had electric or solar power. A conference site visit to Ulithi and Fais documented needs for renovations, water catchment, reliable power and communications.
The source does not identify recipient dispensaries, confirm installation or activation, quantify users or uptime, or prove that teleconsultation or training began; promised units for other states remain prospective, and the handoff is not evidence of Health Center Program delivery.
The Department of the Interior reports that the August 27–28, 2025 Joint Economic Management Committee meeting addressed overdue audits, infrastructure and development plans, and finalization of FSM's FY2026 Annual Implementation Plan. Interior states that FSM receives about $140 million annually under the renewed Compact.
The release documents an oversight and planning event; it does not report approval of a particular health allocation, a health-center award or a patient-level effect.
The FSM Department of Health and Social Affairs reported that a 14-member Philippine medical team visited Chuuk from May 5 through 18 to support Chuuk Hospital staff. The team evaluated 235 patients, performed procedures and surgeries involving 17 patients, repaired 29 idle medical devices, delivered emergency obstetric and newborn-care training, provided prenatal screening and continuing medical education, and assisted in the emergency room.
The source does not identify a directory-listed health-center operator and does not establish permanent staffing, added bed capacity, continuing specialty coverage, grant value, referral or medevac effects, or improved maternal outcomes.
The FSM Department of Health and Social Affairs reported that Pohnpei State Government received essential medications and medical supplies valued at more than $32,000 from the FSM National Government during a February 14 handover. The items were sourced locally from Genesis and MedPharm.
The source does not identify a receiving clinic or hospital or a directory-listed health-center recipient, provide item quantities, document distribution, or report patients served or outcomes; it also does not identify the transfer as Compact, HRSA, Medicaid or Rural Health Transformation funding.
HRSA's 2024 Uniform Data System aggregates four reporting Health Center Program awardees in FSM and 19,791 unique patients. It reports 14,000 patients as uninsured (70.74%), zero as Medicaid/CHIP patients, zero as Medicare patients and 5,791 with other third-party coverage.
These are UDS reporting categories for calendar 2024; they do not prove clinic closure, coverage loss or complete dependence on a single funding stream.
By patients (HRSA UDS 2024). Tap for the full profile.
| Organization | Patients | Sites | Uninsured | Revenue (990) | Resilience | District |
|---|---|---|---|---|---|---|
| Chuuk State Department of Health Services Chuuk | 4,760 | 3 | 84.85% | — | Exposed | FM-99 |
| Yap State Department of Health Services Colonia | 4,556 | 7 | 77.19% | — | Exposed | FM-99 |
| Kosrae Community Health Center Kosrae | 2,081 | 5 | 84.29% | — | Exposed | FM-99 |
| Pohnpei Community Health Center Pohnpei | — | 1 | — | — | Exposed | FM-99 |
| District | Representative | Sites |
|---|---|---|
| FM-99 | 16 |
Federated States of Micronesia ranks #54 by FQHC patients and #48 by organization count among the 57 national-breadth jurisdictions. All 4 centers depend on the federal Community Health Center Fund, authorized only through December 31, 2026.
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FQHC data from the HRSA bulk-sites file + UDS 2024 + IRS 990. State policy profile via NACHC/KFF/AANP. Intelligence items cite primary sources. Federal items apply to all states; state items are Federated States of Micronesia-only. Updated 2026-06-30.