Health Center Program requirements include an obligation under section 330(k)(3)(F) of the Public Health Service Act 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 program income received by non-HRSA sources (e.g., reimbursement from private insurers, Medicare, Medicaid, etc.) These requirements do not impact a health center’s eligibility to submit reimbursement claims for administering Food and Drug Administration (FDA) authorized COVID-19 vaccines under an Emergency Use Authorization (EUA) or FDA-licensed COVID-19 vaccines under a Biologics License Application (BLA)to underinsured individuals to the HRSA COVID-19 Coverage Assistance Fund.
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 appropriately allocating and tracking grant funds.
In accordance with the terms and conditions of the HRSA COVID-19 Coverage Assistance Fund, in order to seek reimbursement, a health center must agree to the following as attested at registration:
- You will accept HRSA COVID-19 Coverage Assistance Fund program reimbursement as payment in full.
- You agree not to balance bill the patient.
If a health center accepts reimbursement from the Coverage Assistance Fund, 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.