Submit your petition to consider your provider data for the final 2018 Essential Community Providers (ECP) List

Submit your petition by October 15, 2016, in order for the Department of Health and Human Services to consider your provider data for the final 2018 Essential Community Providers (ECP) List.

In accordance with section 1311(c)(1)(C) of the Affordable Care Act (ACA), Qualified Health Plan (QHP), including Stand-alone Dental Plan (SADP) issuers are required to include within their network essential community providers (ECPs), where available, that serve predominantly low-income, medically-underserved individuals. Under this same section of the ACA, the Secretary of the Department of Health and Human Services (HHS) is charged with establishing criteria for certification of health plans as QHPs, including criteria for issuer satisfaction of the ECP inclusion requirement. 

To satisfy this ECP requirement, QHP and SADP issuers must submit an ECP template as part of their QHP application, in which they must list the ECPs with whom they have contracted to provide health care services to low-income, medically-underserved individuals in their service areas.

The Department of Health and Human Services (HHS) has compiled a draft non-exhaustive list of available ECPs for plan year (PY) 2018. These providers submitted an ECP petition by July 11, 2016, to be added to the ECP list for plan year 2018 and were approved by CMS through the ECP petition review process. HHS updates this ECP list annually to assist issuers with identifying providers that qualify for inclusion in an issuer's plan network toward satisfaction of the ECP standard 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 and described in section 1927(c)(1)(D)(IV) of the Social Security Act (SSA). 

Submit your petition by no later than 11:59 p.m. ET on October 15, 2016, in order for HHS to consider your provider data for the final PY 2018 ECP List.  The petition is available here.