PFNC Program Overview​​ 

California Welfare and Institutions (W&I) Code §14105.965, enacted on August 2006, authorized the PFNC supplemental reimbursement program. This voluntary Certified Public Expenditure (CPE) based program provides additional funding to eligible governmental entities that provide Clinic services to Medi-Cal beneficiaries. Code of Federal Regulations §433.51 requires that an authorized representative of the contributing public agency certify that the expenditures of the governmental entity meet the eligibility requirements for federal financial participation (FFP). The Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment (SPA) 06-016 on August 8, 2012, authorizing the federal share of the supplemental reimbursement payments based on uncompensated costs for Medi-Cal fee-for-service Public Freestanding Non-hospital-based Clinics services . SPA 16-021 was approved by CMS on December 6, 2016, which makes technical revisions to update the clinic participation criteria in the relevant State Plan pages; specifically, those necessary to reflect hospital authorities that govern selected designated public hospitals.​​ 

Kev tsim nyog tau txais PFNC Program​​ 

To be eligible for the program, a PFNC provider must meet the following requirements, as specified in W&I Code §14105.965:​​ 

• Muab kev pabcuam rau cov neeg tau txais txiaj ntsig Medi-Cal (ntxiv tau txhais hauv SPA 06-016),​​ 
• Tau cuv npe ua Medi-Cal tus kws kho mob rau lub sijhawm thov, thiab​​ 
• Be owned or operated by an eligible governmental entity, to include the state, a city, county, city and county, the University of California, health care district organized pursuant to Chapter 1 of Division 23 (commencing with Section 32000) of the Health and Safety Code, or hospital authority described in section 101850 or 101852, et seq. of the Health and Safety Code, as these laws were in effect as of July 1, 2016 (pursuant to SPA 16-021).​​ 
• Effective July 1, 2008, payment rules for State-owned and operated clinics are governed by the provisions set forth in SPA 08-014; therefore, effective July 1, 2008, such clinics are not eligible to receive supplemental reimbursement under the PFNC Program.​​ 

Cov nqi uas tau thov raws li PFNC Txoj Haujlwm tsis tau thiab yuav tsis raug thov raws li lwm qhov kev pabcuam kom tau txais FFP. Cov kws kho mob tsis tuaj yeem thov cov nqi raws li PFNC Program rau txhua lub sijhawm uas lawv tau thov, tau thov, tau txais cov nyiaj them rov qab thiab / lossis koom nrog cov kev pab cuam pom zoo los ntawm Lub Xeev California thiab / lossis CMS uas cov nqi no tau los lossis yuav raug siv rau muab FFP.​​ 

Cov kws kho mob tsim nyog uas xaiv los koom nrog PFNC Program yuav tsum ua raws li hauv qab no:​​ 

• Nkag mus rau hauv Daim Ntawv Pom Zoo Muab Kev Koom Tes (PPA) nrog Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS), thiab​​ 
• Pom zoo them rov qab rau DHCS rau nws cov nqi tswj hwm cuam tshuam nrog kev tswj hwm PFNC txoj haujlwm.​​ 

Kev them nyiaj rov qab PFNC​​ 

PFNC service providers eligible to participate in this program will receive supplemental reimbursement payments by completing a CMS approved cost report form annually. The supplemental reimbursement payment is based on claiming FFP on expenditures that have been incurred by the public provider and meet the requirements for a CPE. The supplemental reimbursement amount is determined by the methodology approved by CMS in SPA 06-016.​​ 

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Yuav tiv tauj peb li cas​​ 

As a public entity, if you would like to participate in the PFNC Program, or if you have any further questions, send inquiries to: PublicClinics@dhcs.ca.gov.​​