Montana Fact Sheet
Montana Primary Care HPSA Info
HPSAs are defined as any of the following which the Secretary of Health and Human Services determines has a shortage of health professionals:
a) An Urban or Rural Area
b) A Population Group
c) A Public or Non-Profit Private Medical Facility
HPSAs are approved by the federal government (Division of Shortage Designation, Bureau of Primary Health Care, Health Resources & Services Administration). The basic criteria for designation is that 3,500 or more people are served by a single primary care physician. "High need or risk indicators", i.e. high infant mortality rates, high percentage of poverty population may drop the required ratio to 3000:1. The federal government is reviewing HPSAs status every three years.
Types of HPSAs
HPSAs may be awarded based on the following specialities:
A. Primary Medical Care HPSAs - Areas with shortages of Primary Care Physicians (Family Practitioners, General Practitioners, Obstetricians/Gynecologists, Pediatricians, Internal Medicine).
B. Mental Health HPSAs - Areas with shortages Mental Health Professionals (Psychiatrists, clinical Psychologists, Psychiatric Nurses, Psychiatric Social Workers and Marriage and Family Therapists.
C. Dental HPSAs - Areas with Shortages of Dentists, Dental Hygienists, Dental Auxiliaries.
HPSAs may fall into one of three categories by designation type.
I. Geographic designations may be granted to the entire county or to a "Service Area" of the county. If an area is granted a Geographic HPSA designation, all physicians practicing in the area are eligible for:
a. Medicare Incentive Payments - PL 100-203 provides for 10 % bonus payment for Medicare reimbursable physicians services provided within geographic HPSAs. Higher Customary Charges for New Physicians in HPSAs - Public Law 100-203 exempts new physician opening practices in non-metropolitan geographic HPSAs from new Medicare limitations on "customary charges."
b. Assistance from the Public Health Service in recruitment and retention of physicians and practitioners through the National Health Service Corps Scholarship and Federal Loan Repayment Programs.
c. Assistance through the Primary Care Office, Primary Care Association, Area Health Education Center and the State Office of Rural Health in recruitment and retention of providers.
d. Application for Rural Health Clinic certification (when met with other criteria). The Rural Health Clinics Act - PL95-210 provides Medicare and Medicaid reimbursement for services provided by PAs and Nurse Practitioners.
e. Federal Grant Opportunities.
II. If a Population (Medicaid Eligible, Medically Underserved, Migrant, Low Income or Homeless) designation is granted, the 10% Medicare incentive does not apply but selected assistance applies (Ib, Ic, Id, Ie).
III. If a Facilities HPSA is granted for operating facilities of federal or state correctional institutions, mental hospitals, or other public or non-profit medical facilities, you may receive selected assistance (Ib, Ic and Ie).
For More Information Contact:
John Schroeck, M.Ed., CHES
Director Montana Primary Care Office
C305 Cogswell, P.O. Box 202951
Helena, MT 59620
E-mail: jschroeck@mt.gov
Telephone: 406-444-3934
How to Apply
National Health Service Corps Programs
