Essential Community Providers

InsightsClient Alert

Providers who qualify as Essential Community Providers (ECPs) should verify they have been included in the draft list recently released by the Centers for Medicare and Medicaid Services (CMS).  ECPs are defined as providers who serve predominantly low-income, medically underserved individuals.  They include health care providers defined in section 340B(a)(4) of the Public Health Service Act and entities described in section 1927(c)(1)(D)(i)(IV) of the Social Security Act (e.g., 340B providers, rural health clinics, federally qualified health centers).

Designation as an ECP increases the likelihood that Health Plans sold on the Affordable Care Act Exchanges will be required to include the provider in their networks.

The following website includes the draft ECP list to be utilized by Health Plans for 2019.  The Excel file is attached for your convenience.

CMS encourages providers who do not appear on the ECP list but believe they satisfy the ECP inclusion criteria, as outlined within the ECP petition, to submit an online petition at the website below.

The deadline for submitting an ECP petition is Friday, December 22, 2017.

You may submit any questions or requests for additional information to: