Opportunity Information: Apply for CMS 1Z0 12 001
Apply for CMS 1Z0 12 001
- The Centers for Medicare Medicaid Services in the health sector is offering a public funding opportunity titled "CHILDRENS HEALTH INSURANCE PROGRAM REAUTHORIZATION ACT (CHIPRA)PROSPECTIVE PAYMENT SYSTEM (PPS) FOR FEDERALLY QUALIFIED HEALTH CENTERS (FQHCs) AND RURAL HEALTH CLINICS (RHCs) TRANSITION GRANTS SECOND RELEASE" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.767 Childrens Health Insurance Program.
- This funding opportunity was created on Jan 12, 2012 and posted on Jan 11, 2012.
- Applicants must submit their applications by Mar 12, 2012 The Due Date specified on this page cites 1130 pm, the correct time is 1159 pm EDT on 3/12/12. All grant applications must be submitted electronically and be received through www.grants.gov by 1159 pm EDT on 3/12/12 to be considered on time.. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The funding agency has allocated a total of $3,065,655.00 to eligible and selected applicants.
- Each selected applicant is eligible to receive up to $500,000.00 in funding.
- The number of recipients for this funding is limited to 8 candidate(s).
- Eligible applicants include: State governments.
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Opportunity Summary:
This grant opportunity, titled "Childrens Health Insurance Program Reauthorization Act (CHIPRA) Prospective Payment System (PPS) for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) Transition Grants - Second Release," is a discretionary grant program run by the Centers for Medicare and Medicaid Services (CMS). It is designed to help state governments make required payment policy changes in their State Childrens Health Insurance Program (CHIP) in response to federal law. The underlying requirement comes from Section 503 of CHIPRA, which directs state CHIP programs to follow the payment requirements in Section 1902(bb) of the Social Security Act. That section established, for Medicaid in 2001, a prospective payment system for FQHCs and RHCs, and CHIP programs are expected to align with those rules for CHIP-covered services furnished by these clinics.
At its core, the grant is about supporting states as they transition CHIP payment methods for FQHCs and RHCs to either (1) a Prospective Payment System (PPS) or (2) an Alternative Payment Methodology (APM). Under PPS, clinics are generally paid based on a pre-set per-visit rate rather than being reimbursed purely based on charges or cost-based principles after the fact. The APM option allows flexibility, but it is not unilateral: it must be agreed to by the FQHCs and RHCs. The practical goal is to ensure that states have a compliant, predictable, and administratively workable payment approach for these safety-net providers when they deliver services to children enrolled in CHIP.
Funding for this opportunity was estimated at $3,065,655 in total, with an expected 8 awards. Individual awards were anticipated to range from $200,000 (award floor) to $500,000 (award ceiling). The program did not require cost sharing or matching funds, meaning states were not required to contribute a specific non-federal share as a condition of receiving the grant. The funding instrument type is a grant, and the activity category is health. The CFDA number associated with the opportunity is 93.767, which corresponds to the Childrens Health Insurance Program.
Only state governments were eligible applicants. The emphasis on states reflects that CHIP is administered at the state level and that the payment methodology changes required by CHIPRA and the Social Security Act must be implemented through state policy, rate-setting, and coordination with affected providers and, in many cases, managed care entities or third-party administrators. Transition funding like this typically supports time-limited implementation work such as developing rates or methodologies, conducting analyses of existing payment arrangements, updating state plan or program documentation, engaging stakeholders (including FQHCs and RHCs), and making operational system changes needed to pay clinics correctly under PPS or an agreed APM.
This posting was dated January 11, 2012, with a creation date of January 12, 2012. The application deadline was March 12, 2012, with an important clarification that applications had to be submitted electronically through Grants.gov and received by 11:59 pm EDT on 3/12/12 to be considered on time (a correction from an earlier time listed elsewhere on the page). The opportunity was archived on April 11, 2012. For technical issues accessing the full announcement, the listing directed applicants to the Grants.gov Contact Center (1-800-518-4726) or support@grants.gov during standard weekday hours.
In short, this CMS transition grant was meant to help states bring CHIP payment policy for FQHCs and RHCs into compliance with federal PPS requirements (or a mutually agreed alternative), reducing disruption for clinics that serve children and families, and supporting smoother, more consistent reimbursement for essential primary and preventive care delivered through these community-based providers.
Frequently Asked Questions (FAQs)
What is the title of this grant opportunity?
The opportunity is titled "Childrens Health Insurance Program Reauthorization Act (CHIPRA) Prospective Payment System (PPS) for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) Transition Grants - Second Release."
Which federal agency runs this program?
This is a discretionary grant program run by the Centers for Medicare and Medicaid Services (CMS).
What is the main purpose of the grant?
The grant is designed to help state governments make required payment policy changes in their State Childrens Health Insurance Program (CHIP) to comply with federal law, specifically related to how CHIP pays FQHCs and RHCs for CHIP-covered services.
What federal requirement is driving these payment changes?
The underlying requirement comes from Section 503 of CHIPRA, which directs state CHIP programs to follow the payment requirements in Section 1902(bb) of the Social Security Act for CHIP-covered services furnished by FQHCs and RHCs.
What does Section 1902(bb) of the Social Security Act establish?
Section 1902(bb) established (for Medicaid in 2001) a prospective payment system (PPS) for FQHCs and RHCs, and CHIP programs are expected to align with those rules for CHIP-covered services provided by these clinics.
Who is this grant meant to support?
The grant is meant to support states as they transition CHIP payment methods for services delivered by safety-net providers, specifically Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).
What are the two payment approaches states can transition to under this grant?
States can transition CHIP payment methods for FQHCs and RHCs to either (1) a Prospective Payment System (PPS) or (2) an Alternative Payment Methodology (APM).
What is a Prospective Payment System (PPS) in this context?
Under PPS, clinics are generally paid based on a pre-set per-visit rate rather than being reimbursed purely based on charges or cost-based principles after the fact.
What is an Alternative Payment Methodology (APM) in this context?
An APM is an option that allows flexibility in how FQHCs and RHCs are paid under CHIP; however, it is not unilateral and must be agreed to by the FQHCs and RHCs.
Does a state need provider agreement to use an APM?
Yes. The APM option must be agreed to by the FQHCs and RHCs.
What is the practical goal of transitioning to PPS or an agreed APM?
The goal is to ensure states have a compliant, predictable, and administratively workable payment approach for FQHCs and RHCs when they provide services to children enrolled in CHIP.
What is the estimated total amount of funding available?
Total funding for the opportunity was estimated at $3,065,655.
How many awards were expected to be made?
The opportunity anticipated an expected 8 awards.
What was the anticipated range for individual award amounts?
Individual awards were anticipated to range from $200,000 (award floor) to $500,000 (award ceiling).
Is cost sharing or matching required?
No. The program did not require cost sharing or matching funds.
What is the funding instrument type?
The funding instrument type is a grant.
What is the activity category for this opportunity?
The activity category is health.
What CFDA number is associated with this opportunity?
The CFDA number is 93.767, which corresponds to the Childrens Health Insurance Program.
Who was eligible to apply?
Only state governments were eligible applicants.
Why are only states eligible applicants?
CHIP is administered at the state level, and the required PPS/APM payment methodology changes must be implemented through state policy and operations, including rate-setting and coordination with affected providers.
What kinds of activities would these transition grants typically support?
Transition funding like this typically supports time-limited implementation work such as developing rates or methodologies, analyzing existing payment arrangements, updating state plan or program documentation, engaging stakeholders (including FQHCs and RHCs), and making operational system changes needed to pay clinics correctly under PPS or an agreed APM.
When was the opportunity posted and created?
The posting was dated January 11, 2012, with a creation date of January 12, 2012.
What was the application deadline?
The application deadline was March 12, 2012.
How did applicants have to submit their applications?
Applications had to be submitted electronically through Grants.gov.
What time was the application due on the deadline date?
Applications had to be received by 11:59 pm EDT on March 12, 2012 to be considered on time.
Was there any correction or clarification about the deadline time?
Yes. There was a clarification that the correct deadline was 11:59 pm EDT on 3/12/12, correcting an earlier time listed elsewhere on the page.
When was the opportunity archived?
The opportunity was archived on April 11, 2012.
Where could applicants get help if they had trouble accessing the full announcement?
For technical issues accessing the full announcement, applicants were directed to the Grants.gov Contact Center at 1-800-518-4726 or support@grants.gov during standard weekday hours.
What is the broader policy reason for this grant?
The grant supports states in bringing CHIP payment policy for FQHCs and RHCs into compliance with federal PPS requirements (or a mutually agreed alternative), with an emphasis on reducing disruption for clinics that serve children and families and supporting smoother, more consistent reimbursement.
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