1. Program Assistance Letter 2013-10: Program Update: On-Site Compliance Reviews for Initial Designation and Designation Period Changes U.S. Department of Health and Human Services Health Resources and Services Administration Bureau of Primary Health Care September 26, 2013

2. AGENDA Review Process Time Frames Designation Period Changes Resources for Technical Assistance Question & Answer 2

3. Approximate Time Frames Step in Process Approximate Number of Days Preliminary review30 Compliance review90 Optional applicant response 30 (if applicable) Look-alike determination30 3

4. Initial Designation Application Process Application preparation and submission Preliminary HRSA review for completeness and eligibility Compliance review (on-site and paper application) Look-alike determination Optional Interim Applicant Response Disapproval Notice of Look-Alike Designation Newly designated look-alike applies to CMS and State Medicaid agency for FQHC Medicare and Medicaid reimbursement and other FQHC benefits Disapproval Approval Technical Assistance (PCAs, HRSA, NCAs)

5. Designation Period Changes Three-year designation period –Purpose: Align look-alike designation periods with grantee project periods –Initial Designation – from 2 years to 3 years –RD – from 5 years to 3 years These changes will affect existing look-alikes upon their next RD application. 5

6. Technical Assistance Primary Care Associations: http://www.bphc.hrsa.gov/technicalassistance/partnerlinks/ http://www.bphc.hrsa.gov/technicalassistance/partnerlinks/ HRSA Look-Alike Team: 301-594-4300 or lookalike@hrsa.govlookalike@hrsa.gov PAL 2013-10: http://bphc.hrsa.gov/policiesregulations/policies/pal_2013-10.pdfhttp://bphc.hrsa.gov/policiesregulations/policies/pal_2013-10.pdf Site Visit Guide: http://bphc.hrsa.gov/administration/visitguidepdf.pdfhttp://bphc.hrsa.gov/administration/visitguidepdf.pdf Look-Alike TA Webpage: http://bphc.hrsa.gov/about/lookalike/index.htmlhttp://bphc.hrsa.gov/about/lookalike/index.html OR For existing Look-Alikes, contact your assigned Project Officer 6

7. Question & Answer 7