The Medicaid program is the largest source of insurance coverage for low-income and disabled people in the country, and health centers (both Section 330 grantees and look-alikes) play an important role in providing primary and preventive care to Medicaid-covered individuals.

This workshop will provide health centers with an understanding of their enrollment and participation in the Medicaid program together with the associated rights and obligations. The training will further help FQHCs understand their Medicaid per visit rate, whether that rate is derived from a prospective payment system (“PPS”) methodology or alternative payment methodology (“APM”). Knowing how that rate is calculated and what that rate covers is important for health centers as they seek to add or modify their Medicaid-covered services. The workshop will discuss significant legal protections that apply to the payment of a health center’s per visit rate under federal law.

Additionally, the presenters will cover important aspects of the Medicaid program, including Medicaid enrollment requirements, audits, and overpayments. Services or modalities that pose particular challenges for health centers, such as dual eligibles, behavioral health, telehealth, and value-based payments, will be considered. 

Attendees will gain the foundational information they need to understand the rights and responsibilities of FQHCs in the Medicaid program and a framework that will arm them with the tools they need to spot issues and address challenges as they arise.