Under the COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured Program (Uninsured Program), health centers are eligible to seek reimbursement for conducting COVID-19 testing, providing treatment for uninsured individuals with a COVID-19 diagnosis, or for administering an FDA-authorized or approved COVID-19 vaccine to uninsured individuals. Health Center Program requirements include an obligation under section 330(k)(3)(F) for health centers to make “every reasonable effort to collect appropriate reimbursement for its costs in providing health services” from potential payers (see also [Chapter 16: Billings and Collection, Health Center Compliance Manual]). Health Centers are also required to provide financial and budget information relating to nongrant fund program income. These requirements do not impact a health center’s eligibility to submit reimbursement claims to the Uninsured Program.
If a health center also receives Ryan White HIV/AIDS Program grant funds under title XXVI of the Public Health Service (PHS) Act, please refer to the HRSA HIV/AIDS Bureau website for further information. In addition, please continue to ensure that you are allocating and tracking appropriate grant funds.
In accordance with the requirements of the Uninsured Program, in order to seek reimbursement, a health center must agree to the following as attested at registration:
- You will accept defined program reimbursement as payment in full.
- You agree not to balance bill the patient.
Therefore, if a health center accepts reimbursement from the Uninsured Program, it may not balance bill/charge the patient.
For questions about Health Center Program billing and collections, sliding fee discount program, and other requirements please contact Health Center Program Support. More information about the Health Center Program is also available, including FAQs related to COVID-19 and health centers.