Обзор программы PFNC​​ 

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.​​ 

Право на участие в программе PFNC​​ 

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

• Предоставленные услуги бенефициарам Medi-Cal (более подробно определено в SPA 06-016),​​ 
• Быть зарегистрированным в качестве поставщика услуг Medi-Cal в течение запрашиваемого периода, и​​ 
• 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.​​ 

Расходы, заявленные в рамках Программы PFNC, не были и не будут заявлены в рамках какой-либо другой программы для получения FFP. Поставщики не могут претендовать на возмещение расходов в рамках Программы PFNC за любой период времени, в течение которого они заявляли, запрашивали, получали возмещение и/или участвовали в программах, одобренных штатом Калифорния и/или CMS, для которых эти расходы были или будут использованы для получения FFP.​​ 

Поставщики, имеющие право на участие в программе PFNC, также должны соблюдать следующие условия:​​ 

• Заключить Соглашение об участии поставщика медицинских услуг (PPA) с Департаментом здравоохранения (DHCS) и​​ 
• Согласиться возместить DHCS административные расходы, связанные с управлением программой PFNC.​​ 

Возмещение 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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Как с нами связаться​​ 

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.​​