Pangkalahatang-ideya ng Programa ng 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.​​ 

Pagiging Karapat-dapat sa Programa ng PFNC​​ 

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

• Nagbigay ng mga serbisyo sa mga benepisyaryo ng Medi-Cal (mas tinukoy sa SPA 06-016),​​ 
• Magpatala bilang isang tagapagbigay ng Medi-Cal para sa panahon na inaangkin, at​​ 
• 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.​​ 

Ang mga gastos na inaangkin sa ilalim ng Programa ng PFNC ay hindi at hindi kukunin sa ilalim ng anumang iba pang programa upang makakuha ng FFP. Ang mga provider ay hindi maaaring mag-claim ng mga gastos sa ilalim ng PFNC Program para sa anumang yugto ng panahon kung saan sila ay nag-claim, nag-claim, nakatanggap ng reimbursement at/o lumahok sa mga programang inaprubahan ng Estado ng California at/o CMS kung saan ang mga gastos na ito ay ginamit o gagamitin upang kumuha ng FFP.​​ 

Ang mga karapat-dapat na provider na pipiliing lumahok sa Programa ng PFNC ay dapat ding sumunod sa mga sumusunod:​​ 

• Pumasok sa isang Provider Participation Agreement (PPA) kasama ang Department of Health Care Services (DHCS), at​​ 
• Sumang-ayon na ibalik DHCS para sa mga gastusin na pang-administratibo nito na nauugnay sa pamamahala sa PFNC Programa.​​ 

PFNC Reimbursement​​ 

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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Paano makipag-ugnayan sa amin​​ 

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.​​