Are you on the list?
CMS has released its draft 2018 Essential Community Provider list, the list used by Qualified Health Plans in the Marketplace to meet the ECP contracting requirement. Take a look at the announcement below to find out how to determine if you are on the list and if not, how to complete the petition process to get your name on the list. Please note, if you want to submit a petition, you must do so before the October 15, 2016 deadline. Any questions should be directed to essentialcommunityproviders@cms.hhs.gov.
Announcement of Public Release of the Draft HHS Essential Community Provider (ECP) List and Petition for the 2018 Benefit Year:
For the Marketplace’s 2018 benefit year, the Centers for Medicare & Medicaid Services (CMS) has released the updated Essential Community Provider (ECP) Petition to collect more complete data from providers who qualify as an ECP and wish to appear on CMS’s ECP list for the 2018 benefit year. The ECP petition is a web-based questionnaire that is available at the following link: https://data.healthcare.gov/cciio/ecp_petition.
CMS releases an updated list of ECPs on an annual basis to assist issuers in complying with the requirements under 45 CFR 156.235. Under that regulation, ECPs are defined as health care providers who serve predominantly low-income, medically underserved individuals. They include health care providers defined in section 340B(a)(4) of the Public Health Service (PHS) Act; entities described in section 1927(c)(1)(D)(i)(IV) of the Social Security Act (SSA); State-owned family planning service sites, governmental family planning service sites, not-for-profit family planning service sites that do not receive Federal funding under special programs, including under Title X of the PHS Act; or Indian health care providers.
The Draft HHS ECP list for the 2018 benefit year is embedded within ECP petition and can be viewed by clicking the button “Check to see if you are on the list” under question 6 of the petition located at https://data.healthcare.gov/cciio/ecp_petition. Providers included on the draft HHS ECP list for the benefit year 2018 reflect those providers who submitted an ECP petition between December 9, 2015 and July 11, 2016 and were approved by CMS for inclusion on the ECP list through the ECP petition review process. CMS has published this draft HHS list of ECPs to provide entities on the list an opportunity through the petition process to notify CMS of any necessary corrections and missing provider data. In addition, CMS solicits providers who do not yet appear on the HHS ECP list but believe they satisfy the ECP inclusion criteria, as outlined in the ECP petition, to petition to be added to the list.
CMS is accepting petitions from qualified providers until 11:59 p.m. ET on October 15, 2016, for data corrections and additions to be considered for the 2018 ECP List.
Providers who need technical assistance with the ECP petition or may have general questions may receive assistance by emailing their question(s) to the following mailbox: EssentialCommunityProviders@cms.hhs.gov. Providers should write in the subject line of the email the following: “Comments on ECP Petition.”