Essential Community Provider Application and Annual Renewal Form

If you are a facility that wishes to receive contract offers from Qualified Health Plan (QHP) Issuers, you’re in the right place. You can add your facility to the Essential Community Provider (ECP) List, update information that already appears on the list, or remove your facility if you no longer wish to receive contract offers.

The deadline to submit a form for inclusion on the Final PY2028 ECP List is mid-August 2026. See below for more information about the cutoff.

NEW Quick Confirmation Feature! Complete your annual renewal faster than before! If nothing has changed, simply review your consolidated information on our new confirmation page.

Benefits of applying and renewing

CMS strongly encourages qualified facilities to complete the ECP Application and Annual Renewal Form to be included on the ECP List. Issuers seeking certification of QHPs on the Marketplace use the ECP List to identify and contract with ECPs to include within their networks.

Issuers are incentivized to offer contracts in good faith to participating ECPs, so ECP facilities may receive an increased number of contract offers from issuers to participate in their provider networks. Renewing the ECP form ensures providers are included in CMS’s most up-to-date list of qualified ECPs. Updating your facility information makes sure that Issuers have accurate contact information to reach out to ECPs.

Submitting a form is simple!

All you need is 15 - 30 minutes to submit a new application, 10 minutes to report changes, or a few minutes to confirm existing information hasn’t changed. CMS will review your submission for eligibility, and if eligible your facility will appear on the ECP List within 4 - 6 weeks.

Remain a participating ECP by renewing your submission at least annually! 

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About this program

PRA Disclosure Statement:
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-1295. The time required to complete this information collection is estimated to take up to 15 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. This estimate does not include time for training. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.