Tổng quan về chương trình 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.​​ 

Điều kiện tham gia chương trình PFNC​​ 

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

• Cung cấp dịch vụ cho những người thụ hưởng Medi-Cal (được định nghĩa thêm trong SPA 06-016),​​ 
• Được đăng ký làm nhà cung cấp Medi-Cal trong khoảng thời gian được yêu cầu và​​ 
• 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.​​ 

Các chi phí được yêu cầu theo Chương trình PFNC chưa và sẽ không được yêu cầu theo bất kỳ chương trình nào khác để có được FFP. Các nhà cung cấp không thể yêu cầu bồi thường chi phí theo Chương trình PFNC trong bất kỳ khoảng thời gian nào mà họ yêu cầu, đã yêu cầu, nhận khoản hoàn trả và/hoặc tham gia vào các chương trình được Tiểu bang California và/hoặc CMS phê duyệt mà các chi phí này đã hoặc sẽ được sử dụng để có được FFP.​​ 

Các nhà cung cấp đủ điều kiện chọn tham gia Chương trình PFNC cũng phải tuân thủ những điều sau:​​ 

• Ký kết Thỏa thuận tham gia của nhà cung cấp (PPA) với Department of Health Care Services (DHCS)) và​​ 
• Đồng ý hoàn trả cho DHCS các chi phí hành chính liên quan đến việc quản lý Chương trình PFNC.​​ 

Hoàn trả 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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Liên lạc với chúng tôi bằng cách nào​​ 

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.​​