Washington Health Professional Loan Repayment Program

Site Eligibility Criteria

Please note: Additional FHP-specific criteria are listed beginning on page 5. To be eligible, sites must meet the following criteria:

• Provide Comprehensive Primary Care (see page 2) and function as part of a system of care that either offers or ensures access to ancillary, inpatient, and specialty referrals. • Understand and agree that no aspect of the participant’s employer-provided wage will be reduced in any way as a result of the participant’s receipt of the SHP, BHP, or FHP award.

• Have been in business and have patient data for a minimum of one year prior to submitting the site application.

• Use a provider credentialing process including reference review, licensure verification, and a query of the National Practitioner Data Bank (NPDB).

• Adhere to sound fiscal management policies and adopt provider recruitment and retention policies to help the patient population, the site, and the community obtains maximum benefits.

• Charge for professional services at the usual and customary prevailing rates, unless a Free Clinic. • Agree to accept assignments for Medicaid/Medicare beneficiaries and have entered into an appropriate agreement with the applicable state agency for Medicaid and CHIP beneficiaries.

• Sites may not discriminate in the provision of services to an individual: a) because the individual is unable to pay; b) because payment would be made under Medicare, Medicaid, or the Children’s Health Insurance Plan (CHIP); or c) based upon the individual’s race, color, sex, national origin, disability, religion, age, or sexual orientation.

• Prominently display a statement—in a common area and, if applicable, on the site’s website—that explicitly states that no one will be denied access to services due to method of payment or inability to pay. In addition, the signage should clearly communicate that the site accepts Medicare, Medicaid, and CHIP. (Free clinics are exempt from the Medicare, Medicaid, and CHIP statement.) The statement should be translated into the appropriate language(s) and/or dialect(s) for the service area. Please see page 2 for more information regarding the non-discrimination policy.

• Not promise loan repayment to an employee or when recruiting for an employee. The provider application process is competitive, and there are no guarantees that a provider applicant will be awarded even if the site has been preapproved.

• If a site has a payback clause of any kind in the employment agreement/contract—such as a sign-on bonus or moving expense allowance that has a payback clause if the provider leaves before a specified time—it will make the provider ineligible for the program, unless that obligation has been fulfilled prior to the effective date of the contract.