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The Importance of HPSA and MUA Designation

Rural communities in Kentucky are still largely underserved by health care providers. With the expanded range of Medicaid and Medicare services now available as a result of the Patient Protection and Affordable Care Act (“ACA”), rural health care infrastructure needs a shot in the arm to meet the demand. Fortunately, several programs exist to incentivize the provision of rural health care, and Kentucky providers in underserved areas should begin taking advantage of them.

Mother with girl being examined by female pediatrician in clinicThe Health Resources and Services Administration (“HRSA”) has the ability to designate certain areas as a Health Professional Shortage Area (“HPSA”) or a Medically-Underserved Area (“MUA”). Providers in these areas of critical shortage can qualify as either a Federally Qualified Health Center (“FQHC”) or a Rural Health Clinic (“RHC”). The main difference between these two types of entities is that the FQHC designation only applies to non-profits, whereas an RHC is for profit. Both types of providers are eligible for enhanced Medicare payments based on costs. There are a whole host of other incentives to bolster the health care workforce and rural practices in HPSAs and MUAs, including loan repayment and scholarships.

The catch for these benefits is, however, that the RHC or FQHC must be located within a HPSA and MUA that has been designated by HRSA within the past four years. This may be a high hurdle, as some designations date to 1976. Before applying to become an RHC or FQHC, health clinics may first need to get an updated designation from HRSA that the area or population is underserved. In Kentucky, this is done through the office of the Inspector General of the Cabinet for Health and Family Services.

The benefits of these designations are too good to leave on the table, so rural practices should begin the qualification and designation process immediately if they haven’t already done so. Please contact the attorneys of McBrayer for help and guidance through the HRSA designation process or for more information on the benefits of HPSA and MUA designation.

Gina M. Riddell, MPA, is a Research and Compliance Analyst of McBrayer, McGinnis, Leslie & Kirkland, PLLC. Ms. Riddell concentrates her practice in healthcare law and is located in the firm’s Lexington office. She can be reached at griddell@mmlk.com  or at (859) 231-8780.

This article is intended as a summary of federal and state law and does not constitute legal advice.

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