After more than 20 years of waiting and in compliance with item 288 WWWW, the Rockbridge Area Health Center (a Virginia FQHC), respectfully requests the implementation of this policy, along with the new PPS rate effective January 1, 2025.  We also request reimbursement for any unreimbursed costs incurred before the submission in accordance with applicable federal law.

FQHCs are a lifeline to so many underserved Virginians.  Health systems like ours truly address all patient needs, including the barriers they face (such as transportation, language and literacy, medication assistance, and behavioral health needs) in accessing health care services.

In keeping with the applicable legislation, we respectfully request that any timelines associated with the Change in Scope filing, determination, or appeals process be achievable and timely.

• 12VAC30-80-25:B.1 - Reimbursement for federally qualified health centers (FQHCs)and rural health clinics (RHC): Beginning October 1, 2001, and for each fiscal year thereafter, each FQHC/RHC shall be entitled to the payment amount (on a per-visit basis) to which the center or clinic was entitled under BIPA of 2000 in the previous fiscal year, adjusted by the percentage change in the Medicare Economic Index (MEI) for primary care services, and adjusted to take into accountant increase or decrease in the scope of services by the FHHC/RHC during its fiscal year.
• Budge Bill - Item 288 WWWW: DMAS shall implement a process no later than January 1, 2025, for FQHCs to notify the department of any changes in the scope of services offered by an FQHC, pursuant to Section 1902(bb)(3) of 42 U.S.C. 1396a. The department is authorized to reimburse FQHCs for unreimbursed costs, as allowed by the applicable federal law, prior to an initial request for a change in scope under the new process.

Respectfull submitted,

Suzanne Sheridan, CEO

Rockbridge Area Health Center