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HRSA Proposes Rule to Revise, Combine HPSAs, MUPs

Thursday, March 6, 2008 General News J E 4
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ROCKVILLE, Md., March 5 The Health Resources and Services Administration (HRSA) at the U.S. Department of Health and Human Services (HHS) today proposed a new rule that will improve the way underserved areas and populations are designated and target federal resources to the people and communities who need them most.



The notice, printed in today's Federal Register, consolidates the criteria for designating medically underserved populations (MUPs) and health professional shortage areas (HPSAs) into a single new methodology called the Index of Primary Care Underservice.



The proposed rule meets goals of the revision, which were to:



-- create a simpler system for those who seek designation by consolidating the two existing procedures and their sets of criteria;

-- incorporate better measures of health status and access;

-- improve identification of new, currently undesignated areas of need and currently designated areas no longer in need; and

-- minimize unnecessary disruption.



"The new methodology offers a significant improvement in the identification of communities experiencing limited access to primary care services," HRSA Administrator Elizabeth Duke said. "The revisions will help the Department target resources more effectively to areas of greater relative need."



The MUP and HPSA designations currently are used in a number of HHS programs. The major use of MUP designations is to determine health centers' (http://bphc.hrsa.gov/) eligibility to receive federal grants, since health centers are required to serve medically underserved populations. The major use of HPSA designations is by the National Health Service Corps (http://nhsc.bhpr.hrsa.gov/); the NHSC relies on HPSA designations to assign clinicians, who must serve in areas with shortages of health professionals.



HHS' Center for Medicare & Medicaid Services (http://www.cms.hhs.gov/default.asp?) uses geographic and population-based HPSA designations among the criteria to determine if an entity qualifies as a Rural Health Clinic (http://www.cms.hhs.gov/CertificationandComplianc/18_RHCs.asp), a status that results in special methods of determining Medicare and Medicaid reimbursement.



The Index of Primary Care Underservice will provide CMS and HRSA with a single measurement for identifying underserved areas and populations.



Additionally, federal government agencies and state health departments can recommend waiver of the return-home requirements for an International Medical Graduate physician who came to the United States on a J-1 visa in return for three years of service by that physician in a particular HPSA.



A 60-day public comment period commences from the date the notice appeared in the Federal Register. Information on submitting comments is included in the FR notice.



The Health Resources and Services Administration (HRSA), part of the U. S. Department of Health and Human Services, is the primary Federal agency for improving access to health care services for people who are uninsured, isolated, or medically vulnerable. For more information about HRSA and its programs, visit http://www.hrsa.gov. For information on the Health Professional Shortage Area and Medically Underserved Population designations, see Shortage Designation (http://bhpr.hrsa.gov/shortage/).





SOURCE Health Resources and Services Administration
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