Hospitals serving predominately low-income, medically underserved individuals have until Dec. 22 to submit a petition for inclusion on the Centers for Medicare & Medicaid Services (CMS)’ final essential community provider (ECP) list for 2019.
Qualified health plans in the health insurance marketplaces must contract with at least 20 percent of ECPs in their communities to meet CMS network adequacy requirements. Hospitals eligible for inclusion on the ECP list are:
- participants in the 340B Drug Pricing Program;
- critical access hospitals;
- children’s hospitals;
- hospitals eligible for disproportionate share hospital payments;
- sole community hospitals; and
- freestanding cancer centers.
Providers can view the 2019 draft ECP list under question 6 of the petition. CMS anticipates releasing the final 2019 ECP list during the first quarter of 2018. Though the ECP petition submission process is open year-round for ongoing provider updates, petitions received after Dec. 22 will be reviewed for inclusion in the 2020 ECP list.
Contact Director of Policy Erin O’Malley at email@example.com or 202.585.0127 with questions.