I am a board member at Rockbridge Area Health Center (RAHC) -- an FQHC located in Rockbridge County Virginia that helps meet the healthcare needs of over 9,000 individuals. In my time on the board, the demand for expanded services to meet the needs of our Medicaid beneficiaries has grown. We have added staff to address the increasing numbers and healthcare needs of our patients, including dental, medical and behavioral health needs. The ever-increasing cost of space, staff salaries and supplies to meet the needs of the Medicaid population has not been matched by reimbursement for these services for some time. Please make certain that we can continue our services and meet the healthcare needs of the populations we serve.

1. 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.
2. 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, (add your FQHC name) 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.

After more than 20 years of waiting, as a Board member of RAHC, and in compliance with Item 288 WWWW, I respectfully request the implementation of this policy and 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, to compensate RAHC for healthcare services that have been provided to Medicaid beneficiaries without adequate adjustment of the PPS over the past years to cover costs.