Negotiated Rulemaking - Progress

Another month, another meeting, but progress made… I am once again participating this week in the Health Resources Services Administration’s Negotiated Rulemaking Committee. This is the Committee that is reconsidering how the Health Professional Shortage Area (HPSA) and Medically Underserved Area (MUA) designations are constructed. The Negotiated Rulemaking committee was mandated by the 2010 Affordable Care Act. These methods (HPSA and MUA) are used to designate areas eligible for Federal resources such as National Health Service Corps Physicians, Community Health Centers, and a Medicare Physician payment bonus. We have now completed roughly 100 hours of discussion (over a six month period) and have made two decisions of substance this week: - There shall be two designations, (HPSA and MUA/P) not one. - Consensus was obtained on which primary care providers to count. (However, weighting issues are yet to be determined.) The most significant change to current practice is the adding of some non-physician primary care providers such as Nurse Practitioners and Physician Assistants within the primary care count. The committee still needs to complete impact testing for proposed weighting of non-physician primary care providers. And while we now have answered two of 12 questions posed to the committee at the beginning of our process, a tremendous amount of work remains. Our Congressionally mandated target date for a draft final proposal is July 2011. Six months down, four months left.

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