I am a staff member at HealthWorks for Northern Virginia. Through my work, I have seen the demand for expanded services to meet the needs of the Medicaid beneficiaries. Like many centers, HealthWorks has added staff to address the increasing needs of our patients, including psychiatric issues, social determinants of health, and substance use disorders. In addition, Virginia FQHCs provided extensive support during COVID pandemic, including COVID testing and vaccination in their communities.

But doing our part has not come without challenges. Many of the supporting positions required to support these expanded services are not billable, but they are critical to navigating the health system for Medicaid beneficiaries. Additionally, the escalating cost of supplies and salaries for the professionals who care for the Medicaid population has not been matched by the reimbursement for these services. FQHCs are dedicated to preventative and primary care for the VA Medicaid population, and reimbursement needs to reflect this. Therefore, I support these bills to ensure FQHCs can continue to provide quality healthcare services for our Medicaid patients.

• 12VAC30-80-25:B.1-Reimbursement for federally qualified health centers (FQHCs) and rural health clinics (RHCs): 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 account any increase or decrease in the scope of services furnished by the FQHC/RHC during its fiscal year.
   
• Budget 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. After more than 20 years of waiting and in compliance with Item 288 WWWW, HealthWorks for Northern Virginia, 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 prior to the submission in accordance with applicable federal law.

Sincerely,

Iman Khatib

Director of Behavioral Health

HealthWorks for Northern Virginia