Federally Qualified Health Center (FQHC)

Federally Qualified Health Centers (FQHCs) are community-based health care providers that receive grants from the HRSA Health Center Program to provide primary care services in medically underserved areas. FQHCs must meet stringent federal requirements, including providing care on a sliding fee scale based on ability to pay and operating under a governing board that includes patients.

FQHCs may be community health centers, migrant health centers, health care for the homeless programs, and health centers for residents of public housing. They are eligible for 340B participation and are not subject to the GPO Prohibition or the orphan drug exclusion. FQHCs are among the most common 340B covered entity types, serving millions of low-income and uninsured patients annually.

For 340B purposes, FQHCs register their sites in OPAIS as associated sites (not parent-child, following the 2017 terminology change). FQHCs typically rely heavily on contract pharmacy arrangements to dispense 340B drugs to their patients, making contract pharmacy compliance a central focus of their 340B programs.

Manufacturer restrictions on contract pharmacy access have significantly affected FQHCs, as many do not have in-house pharmacies and depend on contract pharmacies to access 340B pricing.