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Health Professional Shortage Areas Frequently Asked Questions

1. What is a Health Professional Shortage Area (HPSA)?

A Health Professional Shortage Area (HPSA) is a geographic area, population group or facility that has been designated federally as having a shortage of health care providers. HPSAs may indicate shortages of primary medical care, dental or mental health providers. The HPSA designation was established by legislation to support the National Health Service Corps but is now used by additional federal and non-federal programs as a requirement or preference.

In Ohio, the Primary Care Office (PCO) works with communities to collect and analyze demographic and provider data to determine areas that are underserved according to federal criteria and to submit applications for designation to the Health Resources and Services Administration (HRSA). For more information on HPSAs, see the Ohio Department of Health HPSA page.

2. Where can I find the most recent information on Health Professional Shortage Area (HPSA) designations?

Visit the Health Services and Resources Administration (HRSA) to look up current primary medical care, dental and mental health HPSAs for your county. For more details regarding HPSAs, including the date of last update and HPSA status, use the “Advanced search by HPSA Type, Score, Metro and Status” option on the “Find Shortage Areas” tool located on the right-hand side of the page.

3. On the HRSA Web site, HPSAs are listed by census tract for my county. How do I determine the census tract for a particular location?

Visit the U.S. Census Bureau to help you determine the census tract for a particular physical address. 

4. On the HRSA Web site, HPSAs are listed by Minor Civil Division (MCD) for my county. How do I determine the MCD for a particular location? 

Visit the U.S. Census Bureau to help you determine the MCD for a particular physical address. The MCD will be located in the geography results next to county subdivision.

5. Is there another way I can determine if my facility is located within a designated Health Professional Shortage Area (HPSA) through the HRSA Web site?

HRSA provides an option to search for a HPSA by address. Use the HPSA by address search tool located on the left-hand side of the page.

6. What programs use HPSA designations to establish eligibility?

Various programs use HPSA designations to determine eligibility, including the National Health Service Corps Scholarship and Loan Repayment Programs, the J-1 Visa Waiver Program, and the NURSE Corps Scholarship and Loan Repayment Programs.  HPSA eligibility requirements vary by program.  For example, National Health Service Corps Programs require that participants be placed in HPSAs with a “designated” status, while the J-1 Visa Waiver Program allows placements in HPSAs with a status of “proposed withdrawal.”

7. How are HPSA designations reviewed for update?

Current HPSA designations are reviewed periodically for update.  The PCO works with communities to collect and analyze demographic and provider data to determine areas that are underserved according to federal criteria and to submit applications for continued designation to HRSA.  If areas do not meet the designation criteria at the time of review, the HPSA status will be updated as “proposed withdrawal.”

8. How are HPSA designations withdrawn?

HRSA officially withdraws “proposed withdrawal” HPSAs when an updated list of HPSAs is published in a Federal Register Notice.

9. If the HPSA designation in my community has been withdrawn and there have been significant changes in the number of providers in the service area, can I request the area be reviewed again?

Yes, a community can request that an area be reviewed again. If data show a provider shortage that meets HPSA designation criteria, an application can be submitted for designation. Please note the PCO may prioritize review of current designations given federal deadlines for periodic updates. To request a review, please see the contact information listed on the HPSA page.

10. How can I find out more about the 10 percent bonus payments for services provided to Medicare beneficiaries by physicians in a geographic primary care HPSA or by psychiatrists in a mental health HPSA?

Physicians who furnish medical care services in geographic primary care HPSAs and psychiatrists who furnish services in mental health HPSAs are eligible to receive a 10 percent Medicare bonus from the Centers for Medicare and Medicaid Services (CMS).  Physicians serving in designated geographic HPSAs may also be eligible to receive an additional bonus for major surgical procedures, referred to as the HPSA Surgical Incentive Payment (HSIP). These bonus payments are made by CMS through December 31 of each calendar year that a HPSA is designated; if a HPSA designation is officially withdrawn, bonus payments are made by CMS through December 31 of that calendar year.  Please visit the CMS Web site for more information regarding these bonus payments.

You may also contact CGS Administrators, the Ohio Medicare Part B carrier, for more information.

11. How do I find out more about the HPSA bonus payment incentive for meaningful use of certified Electronic Health Records (EHR)?

For eligible professionals (EPs) who predominantly furnish more than 50 percent of services in an area that is designated as a geographic HPSA, there is an increased Medicare EHR incentive payment. The amount of the Medicare EHR incentive payment limit for each payment year is increased by 10 percent.  Please visit the CMS Web site for more information regarding this bonus payment.

You may also contact the EHR Information Center, which is available to assist the EHR provider community with inquiries, at 1-888-734-6433. 

12. How does publication of an updated HPSA list in the Federal Register Notice affect facilities that have an “automatic facility” HPSA designation?

Automatic facility HPSAs, designated as a result of the Health Care Safety Net Amendments of 2002 (Public Law 107-251), are not subject to HPSA update requirements and will remain designated.  Automatic facility HPSA status is available for Federally-Qualified Health Centers (FQHCs) funded under section 330 of the Public Health Service Act, FQHC Look-Alikes, those Rural Health Clinics (RHCs) that meet the requirement of providing access to care regardless of ability to pay, and Tribal and urban Indian clinics operating under the Indian Self-Determination and Education Act of 1975 (25 U.S.C. 450) or the Indian Health Care Improvement Act.

Last Updated: 6/2/2014

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