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Shortage Designations
Terri Lang, Project Coordinator
UND Center for Rural Health
October 12, 2011
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
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.
When you think…HPSA
• Think three health professions– Primary Care– Dental– Mental Health
• Think three sub-types– Geographic– Population– Facility
Primary Care HPSAs
Mental Health HPSAs
Dental Care HPSAs
When you think…MUA
• Think Federally Qualified Health Centers (FQHC) or Community Health Centers and FQHC look-a-likes
Medically Underserved Areas/Populations
Who uses the designations
***Approximately 40 federal programs use MUA/P and HPSA designations as eligibility requirements
Designation Needed for Selected Federal ProgramsShortage Designations Options
National Health Service Corps
Federally Qualified Health Center Programs
CMS Medicare Incentive Payment
CMS Rural Health Clinic Program
J-1Visa Waiver
Primary Care HPSA
X X GeographicHPSA only
X X
Dental Care HPSA X
Mental Health HPSA
X X 7/1/04 Geographic only
X
HPSA Subtypes
Geographic HPSA X X X X
Population HPSA X X X
Facility HPSA X X
Medically Underserved Area (MUA)
X X X
Medically Underserved Population (MUP)
X X X
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 to be Rural Health ClinicYou can seek a J1 Visa Physician
• If you are in a Geographic HPSAThere are 10% Medicare Incentive Benefits
o Psychiatrists can receive same incentive benefits beginning 7-1-2004 in a Mental Health Geographic 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.
How a HPSA/MUA is Designated
• DHHS contracts with State Health Department to analyze local areas to determine shortages.
• The rules are very specific in law and regulation.• If it appears the area meets criteria, application is
submitted to Shortage Designation Branch.
Currently taking approximately 3 months or more to make a determination.
The rules are being more strictly interpreted than they were a few years ago.