About the Proposed Rule
|news The Health Resources and Services Administration received many substantive comments on the proposed rule and will consider these comments carefully. Based on a preliminary review of the comments, it appears that HRSA will need to make a number of changes in the proposed rule. Instead of issuing a final regulation as the next step, the U.S. Department of Health and Human Services will issue a new Notice of Proposed Rulemaking for further review and public comment prior to issuing a final rule. (Federal Register Notice, 7-23-2008)
The Notice of Proposed Rulemaking, Designation of Medically
Underserved Populations and Health Professional
Shortage Areas, was originally published on February 29, 2008.
The proposed rule revised and consolidated the
criteria and processes for designating Medically
Underserved Populations (MUPs) and Health Professional
Shortage Areas (HPSAs).
The 60-day comment period was extended twice: an additional
30 days on April 21 (to May 31); and another 30 days on June 2 (to June 30).
The proposed rule was intended to improve the way
underserved areas and populations are designated,
- incorporating up-to-date measures of health
status and access barriers,
- eliminating inconsistencies and duplication
of effort between the two existing processes,
- reducing the effort and data burden on States
and communities by simplifying and automating
the designation process as much as possible
while maximizing the use of technology.
No changes were proposed with respect to the
criteria for designating dental and mental health
HPSAs. Podiatric, vision care, pharmacy, and
veterinary care HPSAs, which are no longer in
use, would be abolished.
Impact of the Proposed Rule
HRSA estimated that more than 90 percent of
designations would be retained and a number
of new designations would be added.
The proposed methodology, using only nationally
available data, would retain a much higher percentage
(91 percent) of the current HPSAs than would
an update using the current HPSA method (50
percent). The new method, using the expanded
need factors, designates many more areas, even
without local data, than does the current method.
With the inclusion of local data, which the
new method also allows, this number would go
Twenty-three States conducted their own
analyses, using local and state data sources.
The consensus is that a large majority
of their areas would be retained, including areas
that have lost or are losing their designations
under the current method. In addition, states
report that the proposed method captured new
areas of need better than the current method,
and the proposed method provides greater flexibility
for identifying rational service areas.
Contact your State's
Primary Care Office representative to discuss
their findings on the impact of the proposed
rule using national, State and local data.