What is an FQHC Look-Alike and what benefits does one receive?

A Look-Alike is an organization that meets all of the eligibility requirements of an FQHC that receives a PHS Section 330 grant, but does not receive grant funding.

Although they do not receive grant funding, Look-Alikes do receive many of the same benefits as FQHCs, including:

• Reimbursement under the Prospective Payment System (PPS), in which Medicare payment is made based on a national rate which is adjusted based on the location of where the services are furnished. The rate is increased by 34.16 percent when a patient is new to the FQHC/Look-Alike, or an Initial Preventive Physical Exam (IPPE) or Annual Wellness Visit (AWV) is furnished.

• Reimbursement under the Prospective Payment System (PPS) or other State-approved Alternative Payment Methodology (APM) for services provided under Medicaid.

• Eligibility to purchase prescription and non-prescription medications for outpatients at reduced cost through the 340B Drug Pricing Program.

• Automatic designation as a Health Professional Shortage Area (HPSA). The HPSA designation provides eligibility to apply to receive National Health Service Corps (NHSC) personnel and eligibility to be a site where a J-1 Visa physician can serve.

For more information about FQHC Look-Alikes, visit the HRSA website.

• For general information about Look-Alikes: https://bphc.hrsa.gov/programopportunities/lookalike/index.html

• For Initial Designation (ID) Application Instructions & Resources: https://bphc.hrsa.gov/programopportunities/lookalike/initialdesignationinstructions