Frequently Asked Questions (FAQs)
Find your HPSA answers here.
Frequently Asked Questions
- We have specialized solely in HPSAs for over 15 years; it's our passion. When we take you on as a client we will not rest until every possibility has been considered to optimize your chances for designation.
- We have the experience to assess the feasibility of your HPSA application with extreme accuracy, even with just a preliminary study.
- We have completed more than 100 successful designations throughout the United States.
- We directly contact your state Primary Care Officer before the project commencement to ensure the best outcome for your service area.
- Our state-of-the-art mapping programs, databases, and survey methods ensure quality and precision throughout the entire process.
A Heath Professional Shortage Area – HPSA – is a designation that recognizes a particular geographical area, population, or institutional facility that is experiencing a shortage of primary care services. Once a HPSA designation is achieved, the government commits to assist by infusing aid through various programs and incentives, which make the area more attractive to physicians. As these professionals establish their practices within a HPSA, the shortage of primary caregivers is alleviated, government assistance is eventually withdrawn, and the physicians frequently put down permanent roots within their service area to the mutual benefit of their careers, families, and the community.
The three categories of HPSA designations are primary, mental, and dental health care. Although the shortage study is conducted on specific specialties, many additional specialties benefit from the designation once it is established. For example: a primary care HPSA is based on data from general internal medicine, pediatrics, ob/gyn, and family practice; in addition to these specialties, others such as surgeons, chiropractors, optometrists, and even advanced practitioners in the designated area can receive the benefits.
Once achieved, designation places your area or facility in priority contention for grants and other funds. More directly, the benefits include access to state and federal programs providing physician recruitment assistance and financial incentives, which may include student loan forgiveness and Medicare bonuses to providers practicing in a HPSA area. For more information about the different benefits, see the following:
- Medicare bonus
- Medical Education Loan Repayment
- Designation Requirements for Selected Federal Programs
RHCs receive special Medicare and Medicaid reimbursement rates. The way these clinics are set up to maximize efficiency improves access to healthcare in rural areas. HPSA Acumen can set up your RHCs and help significantly increase the financial return of a practice.
We have the staffing and the know-how to conduct the needs assessment on short notice, too.
We know the intricacies of HPSA designations and how to obtain all benefits. We will give you personalized service to ensure full utilization of all benefits.
All physicians providing services in a geographic, primary care HPSA are eligible to receive bonus payments. The key to eligibility is where the service to the Medicare patient is actually provided. If a service is delivered within the HPSA, the physician receives the bonus.
Eligible providers include primary care physicians, specialists, surgeons, doctors of podiatric medicine, licensed chiropractors, and optometrists. In addition, psychiatrists furnishing services in a geographic mental health HPSA are also eligible to receive a bonus payment.
HPSA Scores are developed for use by the National Health Services Corps (NHSC) and Health Resources and Services Administration (HRSA) to prioritize the need of designations. Based on the severity of a health professional shortage, scores range from 1 to 25 for primary care and mental health, and 1 to 26 for dental health. The higher the score, the greater the need for additional medical services, which increases an area’s priority for placement of new practitioners (eligibility for acquiring NHSC recruits is typically a score of 14 or higher). Several factors go into determining a score, such as providers-to-population ratios, poverty levels, and the incidences of infant mortality or low-birth weights.
HPSA designations must be updated every three years. At 3.5 years, the Federal Government is able to withdraw the designation and the benefits that go with it. The update procedure is identical to the original application.
There are three types of HPSA designations: Geographic, Population, and Facility. Geographic HPSAs have a shortage of providers for the total population within a geographic area; Population HPSAs have an underserved population group such as the Low-Income or migrant farm workers; Facility designations are Community Health Centers, Rural Health Clinics, Federal and state correctional facilities whose facility is underserved and in need of a HPSA.
A J-1 visa, also called an "exchange visitor visa," is used by foreign nationals who come to the U.S. for the purpose of teaching, training, studying, research, etc. Foreign nationals are required to physically return to their home country or the country of last residence for at least two years before they are eligible to apply for any other non-immigrant visa or for "Lawful Permanent Residence." A visa waiver will waive the requirement for the foreign physician to return home for two years in exchange for working in an underserved area.
The H-1B petition allows an employer to temporarily employ a foreign worker in the U.S. on a non-immigrant basis in various specialty occupations. The H-1B petition authorizes the worker to work for a limited period of time for the specific employer and in the specific position outlined in the petition. More information may be found at The United States Department of Labor - Foreign Labor Certification.
For the J-1 visa waiver application, either the employer or physician may pay the filing fees. According to Department of Labor regulations, the sponsoring employer is required to pay the filing fees for the H-1B portion of the case. For a reference, see this link.
With an approved site application, the process usually takes about eight months from the time the Department of Health and Hospitals (DHH) receives the J-1 visa waiver request packet to the time the physician begins work. However, delays related to recruitment efforts, contract negotiations, and J-1 visa waiver processing at the Bureau of Citizenship and Immigration Services (BCIS) may prolong the process. Therefore, DHH cannot guarantee when the J-1 visa waiver physician will actually be able to begin practicing. If you are in immediate need of a physician, this program may not be the appropriate choice for your site.
A person holding a J-2 visa may apply to the Bureau of Citizenship and Immigration Services (BCIS) for an Employment Authorization Documentation (EAD). An EAD would allow a J-2 visa holder to work for as long as the EAD is valid, which is normally one year. This procedure should be cleared through the Department of Labor (DOL) or the Bureau of Citizenship and Immigration Services (BCIS) or by calling 1.800.375.5283.
The National Health Service Corps (NHSC) is a federally funded program that is part of the U.S. Department of Health and Human Services and is housed in the Health Resources and Services Administration’s Bureau of Health Professions. The NHSC is composed of a unique group of clinicians providing primary health care to adults and children in the communities of greatest need across the nation, bringing quality primary health care professionals to communities in need, as well as supporting their efforts to build a better system of care.
NHSC members are required to practice full-time for a minimum of two years (or part-time for four years) at an NHSC-approved location. Take a look at the Student Loan Relief page for further details.
This program ended in June 2008. The Medicare Modernization Act of 2003 (MMA), Section 413a, required that an additional 5% bonus payment be made to physicians in designated PSAs. This bonus was in addition to the amount of payment that would be made for services rendered by physicians. Physician scarcity designations were based on the lowest primary care and specialty care ratios of Medicare beneficiaries to active physicians in every county and census tract. Based on the amount actually paid (not the Medicare-approved payment amount for each service), Medicare paid a 5% physician scarcity bonus on a quarterly basis. A single service may be eligible for both the new physician scarcity bonus as well as the current HPSA bonus payment. Payment was based on the Zip Code of where the service was performed.
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