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| HHS/HRSA | RIN: 0906-AA44 | Publication ID: Spring 2009 |
| Title: Designation of Medically Underserved Populations and Health Professional Shortage Areas | |
| Abstract: This rule would consolidate the processes for designating areas of health professional shortage (HPSAs) and areas of medical underservice (MUAs) that apply in several Department programs, and would improve the criteria for designating medically underserved populations and Primary Care HPSAs. An NPRM was published on September 1, 1998, and due to extensive comments received, a notice was published on June 3, 1999 which announced the decision to publish a new NPRM for public comment. The second NPRM was published on February 29, 2008, with the comment period extended twice (first on April 21, 2008, and again on June 2, 2008). Substantial comments were received that must be reviewed and considered on development of modifications to the rule. A Federal Register Notice published on July 23, 2008 announced the agency decision to review and develop a modified proposal and publish another NPRM at a future date. Options are currently under development and consideration. This rule would consolidate the processes for designating areas of health professional shortage (HPSAs) and areas of medical underservice (MUAs) that apply in several Department programs, and would improve the criteria for designating medically underserved populations and Primary Care HPSAs. An NPRM was published on September 1, 1998, and due to extensive comments received, a notice was published on June 3, 1999 which announced the decision to publish a new NPRM for public comment. The second NPRM was published on February 29, 2008, with the comment period extended twice (first on April 21, 2008, and again on June 2, 2008). Substantial comments were received that must be reviewed and considered on development of modifications to the rule. A Federal Register Notice published on July 23, 2008 announced agency decision to review and develop modified proposal and publish another NPRM at a future date. Options are currently under development and consideration. Historically, a variety of methodologies have been used by a variety of Federal and state programs to target resources to underserved populations, including MUAs and HPSAs. MUAs have not been updated in many cases for over 20 years, and therefore, may not reflect current conditions in many areas. Statutory citations above provide the legal foundation for the existing designations. While there is no statutory requirement to update MUAs, there is a requirement to update HPSAs. However, there is no requirement to update the HPSA methodology. Alternatives are to continue to use the existing methodologies or develop another new approach for one or the other. Anticipated costs are minimal, in part, because the infrastructure is already in place for designations, and it would just take a different approach. No direct impact is expected on most major programs that use the designations, whose funding levels depend on appropriations. There is potential impact on Medicare Incentive Payments (MIP), but it is relatively small, and depending on the results of the model selected, could increase or decrease payments. Potential benefits and risks of an updated methodology: A benefit would be improved targeting of resources (grants and health professionals) to areas and populations with demonstrated need for assistance to assure access to health care services. A risk would be that some areas currently qualified for some programs could lose eligibility based on lower relative need. | |
| Agency: Department of Health and Human Services(HHS) | Priority: Other Significant |
| RIN Status: Previously published in the Unified Agenda | Agenda Stage of Rulemaking: Long-Term Actions |
| Major: No | Unfunded Mandates: No |
| CFR Citation: 42 CFR 5 42 CFR 51c (To search for a specific CFR, visit the Code of Federal Regulations.) | |
| Legal Authority: 42 USC 254b 42 USC 254e | |
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Legal Deadline:
None |
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Timetable:
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| Regulatory Flexibility Analysis Required: No | Government Levels Affected: None |
| Federalism: No | |
| Included in the Regulatory Plan: No | |
| RIN Data Printed in the FR: No | |
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Agency Contact: Andy Jordan Senior Analyst, Office of Shortage Designation, Bureau of Health Professions Department of Health and Human Services Health Resources and Services Administration Room 8C26, 5600 Fishers Lane, Room 9A-18, Parklawn Building, Rockville, MD 20857 Phone:301 594-0197 Fax:301 443-4370 Email: ajordan@hrsa.gov |
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