Support Single Patient Definition for FQHCs

Summary#

This House resolution (H. Res. 1558) says that Federally Qualified Health Centers (FQHCs) should keep using their longstanding single patient definition for delivering all services, including prescription drugs bought through the 340B Drug Pricing Program. The resolution notes there are nearly 1,400 health centers serving more than 32 million people at over 16,000 sites. It says health centers serve many children, rural residents, and people enrolled in Medicare or Medicaid or who are uninsured, and that about 90 percent of health center patients have incomes at or below 200 percent of the federal poverty line. The resolution cites the Health Resources and Services Administration (HRSA) single patient definition: an individual with at least one countable visit during the calendar year in categories such as medical, dental, mental health, substance use disorder, vision, other professional, or enabling services. The resolution argues that the single definition lowers administrative costs, supports coordinated care under the patient-centered medical home model, and helps health centers use 340B discounts to reach more patients. The resolution was referred to the House Committee on Energy and Commerce.

What it means for you#

If you get care at an FQHC, this resolution expresses the House's view that health centers should continue to count a patient once per year across many types of services, so those patients can access medical care, dental care, mental health care, substance use disorder services, vision care, and prescription drugs purchased under 340B. No publicly available information on whether the resolution would itself change legal requirements or funding.

Expenses#

No publicly available information.

Proponents' View#

Supporters say the single patient definition:

  • Lowers administrative costs and increases health center effectiveness.
  • Lets health centers coordinate care across multiple providers without breaking the patient’s relationship with their primary care provider (the patient-centered medical home idea).
  • Allows health centers to provide 340B prescription drugs to all their patients so scarce federal resources can reach more people. Supporters also note prescription drug affordability is a concern and point to existing programs such as the Medicaid Drug Rebate Program and the 340B program.

Opponents' View#

No publicly available information.