Federally Qualified Health Center PPS: Grandfathered Tribal FQHCs
Guidance for Indian Health Services and tribal facilities and organizations seeking to become certified as grandfathered tribal FQHCs.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: March 23, 2018
A tribe or tribal organization clinic can get certified and paid as a grandfathered tribal FQHC, if it’s:
- Operating under the Indian Self-Determination Act
- Billing as a provider-based to an Indian Health Services (IHS) hospital
- No longer operating as a provider-based department of an IHS hospital
- Meeting conditions in 42 CFR 413.65(m) on or before April 7, 2000
- Changed status from IHS to a tribal operation, or vice versa, on or after April 7, 2000
- Realigned the clinic from IHS or tribal hospital to another IHS or tribal hospital, such that the organization no longer meets the Conditions of Participation (CoPs)
- Meeting all FQHC certification and payment requirements
Important Links
Payment Policy/Billing
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