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Essential Community Provider Petition

for the 2024 plan year


The ECP List currently displayed on this website is the rolling draft Plan Year 2023 ECP List, updated monthly to include recently approved provider petitions. This ECP List can be viewed by clicking "Check to see if your facility is on the ECP List" below.

For ongoing provider updates, the ECP petition submission process remains open year-round. Provider petitions submitted between August 19, 2021 and mid August 2022, will be reviewed for inclusion on the final Plan Year 2024 ECP List. Provider petitions submitted after mid August 2022, will be reviewed for inclusion on the final Plan Year 2025 ECP List.
 
Background
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. Under 45 Code of Federal Regulations (CFR) 156.235, the Secretary of HHS has established criteria for inclusion of a sufficient number and geographic distribution of ECPs, where available, in an issuer’s network to ensure reasonable and timely access to a broad range of such providers for low-income, medically-underserved individuals in their service areas. 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 non-exhaustive list of available ECPs. These providers submitted an ECP petition to be added to the ECP List or update their existing data on the list 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; entities described in section 1927(c)(1)(D)(IV) of the Social Security Act (SSA), including State-owned family planning service sites, governmental family planning service sites, not-for-profit family planning service sites that do not receive Federal funding under special programs, including under Title X of the PHS Act or other 340B-qualifying funding; or Indian health care providers, unless any of the above providers has lost its status under either of these sections, 340(B) of the PHS Act or 1927 of the SSA, as a result of violating Federal law.
 
Instructions
For clarifications regarding specific questions within the ECP petition, click on the information icon that follows each question for additional information. If you are experiencing issues with entering data into or submitting the form, please use one of the supported browsers: Google Chrome, Apple Safari, and the most recent version of Microsoft Edge. Warning: you may not be able to successfully complete the form if you are using Internet Explorer 11. If you need help beyond the tips provided here, you may reach us via email at essentialcommunityproviders@cms.hhs.gov.
Petition form
Requested Action
Are you petitioning to add your facility to the ECP List, change/update or add missing data to your facility information that already appears on the ECP List, or remove your facility from the list?
About you, the person completing this provider petition
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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, expiration date is 12/31/2021. The time required to complete this information collection is estimated to take up to 60 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.