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Provider Manual

Program Overview

Last Updated on January 24, 2019

The Family Health Center of Marshfield, Inc. is a federally funded community health center from the U.S. Public Health Services under Section 330 of the Public Health Service Act for the purposes of providing health care coverage to certain medically underserved residents. The Family Health Center program strives to improve members’ health through a focus on preventive and primary care services.

The Family Health Center program is not an insurance plan. However, it uses many of the same procedures that are used by private insurance to assist its members.

Family Health Center contracts with Security Health Plan to provide administrative functions for Family Health Center members.

Last Payer Status

Family Health Center is a grant funded community health center program. Community health centers are authorized by Congress under Section 330 of the Public Health Services Act (as amended by the Health Center Consolidated Act of 1996). The services provided or arranged for are directed by the Act, related regulations, as well as from the governing board. As a community health center, Family Health Center is required to obtain payment from all third parties prior to the use of grant support including any BadgerCare Plus dollars.

Family Health Center is funded with federal discretionary health dollars. As further evidence of “payer of last resort” status, Congress in the Omnibus Budget Reconciliation Act of 1989 and 1990, mandated that State and Medical Assistance programs reimburse Family Health Center at 100 percent of reasonable costs of services to Medical Assistance recipients. In doing so, Congress has indicated that these discretionary grant dollars not be used to fund services covered by state Medical Assistance programs.