Deadline Looms for Essential Community Provider Filing

Petitions for 2019 List Must Be Submitted by Dec. 22

December 18, 2017 02:32 pm News Staff

Family physicians and other qualified health care professionals only have until Dec. 22 at 11:59 p.m. EST to submit a petition(data.healthcare.gov) to be considered for inclusion in the essential community provider (ECP) list for 2019 marketplace health plans.

[sign with march december and number 22]

In addition, physicians in clinics or other facilities currently listed as ECPs -- defined by federal regulation as those that serve predominantly low-income and medically underserved populations -- may want to check the 2019 draft list(data.healthcare.gov) for errors and submit corrections and updates to their clinic information, if necessary.

CMS also updates provider data on the ECP list throughout the year and makes revisions such as updating provider contact information, verifying the types of health services that are available at specific provider facilities, and removing provider practices that are no longer in business or that are not accepting plans purchased through a marketplace exchange.

CMS issues an updated list of ECPs annually to help qualified health plan issuers comply with federal requirements(www.govregs.com) that address health plan network adequacy standards.

CMS then uses the list as the basis for determining the number of available ECPs in a qualified health plan's service area.

Physicians who have questions about the ECP petition or who need technical assistance to gain access can email questions to CMS with the subject line "Comments on ECP Petition."

Additional Resource
CMS: Qualified Health Plan Certification Information and Guidance(www.qhpcertification.cms.gov)