Some insureds may question the role of federally qualified health care facilities (FQHC) in the provision of abortions, both in states that allow abortions and those that ban it. FQHCs are outpatient clinics that qualify for specific reimbursement systems under Medicare and Medicaid. They include Health Center Program award recipients, which receive grant funding from the Health Resources & Services Administration (HRSA) to provide primary care services in underserved areas.
Under present federal regulations, FQHCs must stay in compliance with all applicable federal, state, and local laws. Further, abortions cannot be directly or indirectly funded by federal funds – they are considered outside the scope of the health center grant. Because federal funds cannot be put toward providing abortions and all FQHCs are required to follow applicable state and local laws, if the FQHC is in a state where abortions are prohibited, the FQHC cannot provide abortions. If the FQHC is in a state where abortions are legal, they can provide abortions so long as they do not use federal funds. In other words, the FQHC seeking to provide abortions in a state where it is legal must be financially self-sustaining and will need to fiscally separate out supplies and time used to provide abortions. Given that many FQHC patients have limited ability to pay for services and that there are limited sources of reimbursement for abortions, it is likely that few FQHCs are performing abortions, even in those states where they are permitted.
This essay was provided to ProAssurance by the Starnes Davis Florie LLP law firm.
Published 7/13/2022