Federally Qualified Health Center (FQHC) Medicare Enrollment Guidance Updated
Updated Guidance on FQHC Medicare Enrollment Requirements & Effective Date:
• Various portions of Section 2826 of the SOM are being revised to streamline the process for initial issuance of a Medicare
FQHC participation agreement. Revisions:
o Reduce the number of documents the Medicare Administrative Contractor (MAC) must forward to the Centers for Medicare & Medicaid
Services (CMS) Regional Office (RO) along with the MAC letter recommending approval;
o Clarify that it is the responsibility of the FQHC to understand whether or not it requires a Clinical Laboratory Improvement
Act (CLIA) certificate when it attests to its compliance with FQHC regulatory requirements; the RO does not make a separate
determination on this.
o Clarify that the effective date of the Medicare FQHC agreement is the date on which the MAC determined that the FQHC application
• Exhibit 177 is being revised to include instructions to the applicant and add space for the applicant’s address and a “doing
business as” name, if applicable.
• Exhibit 179 is being revised to track the changes in Section 2826.