Publication Date

Publication Date: 

For the health Exchange Marketplace’s 2017 benefit year, the Centers for Medicare & Medicaid Services (CMS) has released an 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 2017 benefit year. The ECP petition is a Web-based questionnaire that is available at the following link:

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 and described in section 1927(c)(1)(D)(i)(IV) of the Social Security Act (SSA), including governmental family planning service sites and not-for-profit family planning service sites that do not receive funding under Title X of the PHS Act or other 340B-qualifying funding, and Indian health care providers.

HHS has compiled a non-exhaustive list of available ECPs, based on data it and other federal partners maintain, which has been used as an initial source of ECP information.  The draft HHS ECP list for the 2017 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. 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 qualify as an ECP and do not yet appear on the HHS ECP list to petition to be added to the list.

CMS is accepting petitions from qualified providers until 11:59 p.m. EST on January 15, 2016, for data corrections and additions to be considered for the 2017 ECP list (Deadline extended by CMS in early January).