The US Department of Health and Human Services Office of Inspector General (OIG) concluded that a proposed restructuring of a loan and other contractual relationships between a health system and a federally qualified health center (FQHC) “look-alike” clinic would not trigger an enforcement action under the Anti-Kickback Statute, The National Lw EReview reports. The opinion underlines efforts by some hospitals to align with FQHC look-alike clinics to manage their patients’ primary care needs.
FQHCs and FQHC “look-alike” clinics provide primary care to low-income or otherwise disadvantaged populations that often have significant clinical and social service needs. In recognition of the challenges of serving these populations, various federal policies afford these clinics access to funding opportunities and special benefits unavailable to hospitals and other providers. Notably, clinics designated as an FQHC or FQHC look-alike are entitled to cost-based Medicare and Medicaid reimbursement rates, which are significantly higher than the rates for similar services provided at an outpatient hospital department. Read more.
