Update on HPSA/MUA Rulemaking Process

January 12, 2012

The Affordable Care Act requires the Department of Health and Human Services (HHS) to establish revised methodologies and criteria for designating Health Professional Shortage Areas (HPSAs), which impacts the National Health Service Corps (NHSC) because all participants must serve in a HPSA.  To accomplish this, the law required the Secretary to appoint a committee to provide recommendations, through a negotiated rulemaking process.  

In July 2010, the Negotiated Rulemaking Committee on the Designation of Medically Underserved Populations and Health Professions Shortage Areas (the Committee) was established by HHS and Committee membership announced.  The Committee was made up of 28 members representing a range of stakeholders, including representatives of community health centers, rural health clinics, health providers, and underserved populations.

On October 13, 2011, after 14 months of work, the Committee voted 21 to 2, with 5 members absent, to endorse their full package of recommendations.  While the majority of the Committee supported the full package, unanimous consensus was required to provide the Secretary with a proposed rule.  In the absence of consensus, the Affordable Care Act requires the Secretary to publish an interim final rule on designating HPSAs and MUAs.    HHS is now working to develop the interim final rule, taking into consideration the Committee’s work and report.

The NHSC will continue to monitor the designation process and inform NHSC sites and participants to any changes.  It is important to note that any participant serving at an NHSC site that loses its HPSA designation is able to fulfill his or her obligation at that site; however, in order to receive a continuation contract, the individual must transfer to another NHSC site.