FEDERALLY QUALIFIED HEALTH CENTERS
The Jorgensen Law Office counsels and represents numerous section 330 grant funded and "look-alike" Federally Qualified Health Centers ("FQHCs") in maintaining compliance with the numerous Federal, State and local laws which apply to FQHCs. This regulatory framework can be difficult to navigate as each business transaction and the overall operations of the FQHC must comply with the requirements of the Health Resources and Services Administration ("HRSA"), the Centers for Medicare Services ("CMS"), section 501(c)3 of the Internal Revenue Code, the Federal Anti-Kickback and Stark laws, the California Anti-Kickback and self-referral laws, the California Department of Health Care Services ("DHCS"), the California Department of Public Health licensure requirements, as well as local county regulations.
Common FQHC legal services we provide include:
- Legal advice and guidance to FQHC leadership during strategic planning to avoid issues of non-compliance.
- Addressing disputes with DHCS regarding the FQHCs Prospective Payment System (PPS) rate.
- Scope of Project issues including proper completion of Form 5A, 5B and 5C
- Adding addition service sites both with HRSA and CDPH
- Representing FQHCs in audits conducted by Medicare, Medi-Cal, and HRSA
- Appealing DHCS or Medicare audit findings, including those related to overpayment assessments, PPS reconciliation reports, PPS rate settings audits and home office costs reports.
- Drafting legal contracts for services, both employment or independent contractors, which satisfy HRSA and comply with the Federal and State Anti-Kickback laws.
- Contract or reimbursement disputes with county designated mental health payers
- HIPAA and patient privacy compliance and breach reporting
- Negotiating and drafting legal documents related to medical practice acquisitions by FQHCs which recognize the organizations non-profit status, avoid private inurement, the time requirements for HRSA scope changes and CDPH licensure.
- Education and legal counsel to the FQHC board of directors to ensure governance compliance under the IRS, HRSA and California state law.
- Section 340b drug discount program participation
- Drafting policies and procedures
- Establishing start-up FQHC's