HPSAs MUAs

What are they?

How can they benefit my practice/my health center?

Patrick J. Durkin, M.A.

Primary Care Office Manager

Indiana State Department of Health

2 N. Meridian St. 8B, Indianapolis, IN 46204

317-233-7846, 317-233-7761 fax

pdurkin@isdh.state.in.us

Shortage Designations• HPSA

Health Professional Shortage Area• MUA/P

Medically Underserved Area/Population• What are they:

A way to identify areas of greatest health needs so limited resources can be prioritized and given to those most in need of primary health services

When you thinkHPSA

Think Health Professions:Primary Care HPSADental HPSAMental Health HPSA

Subtypes under all of theseGeographic HPSAPopulation HPSAFacility HPSA

When you thinkMUA

Think Federally Qualified Health Centers (FQHC).

At least 37 federal programs use MUA/Ps and HPSA designations.

Other types of health institutions and professions benefit from HPSA/MUAs but the general focus is primary care rather than specialties.

Legislation

• Original legislation enacted by Congress in 1970s, Sections 330 MUA/MUP and 332 (HPSA) of Public Health Service Act as amended.

• Most recently, Health Care Safety Net Amendments authorized automatic facility HPSA designation process for Federally Qualified Health Centers and a simple HPSA application process for Rural Health Clinics.

How a HPSA/MUA is Designated

The US Department of Health & Human Services (HHS) contracts with a State Health Department to analyze a local area to determine whether there is a shortage of primary care physicians, dentists or mental health professional.

The rules for this are very specific in law and regulation.If it appears the area meets the requirements, the

information is submitted for final determination to HHS. The federal section doing designations is taking from 3 to 6 months or more to make a determination. The rules are being more strictly interpreted than they were a few years ago.

Primary Benefits

If you are in a HPSA:

You can apply for National Health Service Corps (NHSC) loan repayment or a NHSC scholar.

You can apply for State Loan Repayment Program – a health professional loan repayment program.

You can apply to be Rural Health Clinic.

You can seek a J1 Visa Physician.

More Benefits

If you are in a Geographic HPSA:

There are 10% Medicare Incentive Benefits.

Psychiatrists can receive the same incentive benefits beginning July 1, 2004 in a Mental Health Geographic HPSA that is not in a Primary Care HPSA.

Primary Benefits

If you are in a MUA/P:

You can apply to be Federally Qualified Health Center. (FQHC) or a FQHC look alike.who are both Automatic HPSAs.

You can apply to be Rural Health Clinic (RHC)who can obtain a Automatic HPSA.

You can seek a J1 Visa Physician.

Designation Needed for Selected Federal Programs

Shortage Designations Options

National Health Service Corps

State Loan Repayment Program

Federally Qualified Health Center Programs

CMS Medicare Incentive Payment

CMS Rural Health Clinic Program

J-1Visa Waiver

Primary Care HPSA

X X X Geographic

HPSA only

X X

Dental Care HPSA X X

Mental Health HPSA

X X 7/1/04 Geographic only, ask CMS

X

HPSA Subtypes

Geographic HPSA X X X X X

Population HPSA X X X X

Facility HPSA X X X

Medically Underserved Area (MUA)

X X X

Medically Underserved Population (MUP)

X X

Governor’s Exceptional MUP

X X

Primary Care HPSA

Dental HPSA

Mental Health HPSA

Many of the MUA are from the 1990ties.Many of the MUA are from the 1990ties.So they use the 1990 census tracts.So they use the 1990 census tracts.

MUA