Underserved Areas of Texas

A HPSA Designation is defined as an area, facility, or population group with a shortage of primary care physicians, as defined by a population-to-primary care physician ratio of at least 3, 500:1 and other requirements specified in the federal designation criteria. Indicators of need for primary medical care such as the poverty rate, infant mortality rate, and fertility rate (live births per 1,000 female population) are also considered, as well as indicators of insufficient capacity to meet existing needs. The HPSA designation can qualify areas and population groups for benefits under the following programs: 

  1. Medicare Physician Incentive Bonus Payments - The HPSA bonus is a 10 percent incentive payment that is paid to physicians only when their services are covered by Medicare and are performed within the geographic boundaries of a HPSA area. For more information on the program and for instructions on how to claim the bonus visit the Trailblazer Web site
  2. National Health Service Corps (NHSC) Placement Program 

- NHSC Scholarship
- NHSC Loan Repayment  

  1. Rural Health Clinic Act - Provides cost-based reimbursement to RHCs for physician services provided under Medicaid and Medicare programs. For certification information visit the  DSHS Web site
  2. Physician Education Loan Repayment Program  

MUAs and MUPs are defined as areas or population groups with a quantifiable shortage of personal health services as defined by U.S. DHHS designation area criteria. For geographic designations (MUAs), an Index of Medical Underservice (IMU) score is calculated based on a statistical process that takes the individual area's poverty rate, infant mortality rate, percentage of aged population, and primary care physicians per 1,000 population and compares it with national averages. Individual population groups in areas not qualifying as MUAs can qualify as MUPs using the IMU method or a process whereby the population group's unusual local conditions are documented to result in a barrier to access to health care. The latter process requires the Governor of Texas to submit a recommendation to the federal government for MUP designation of the specific population group. MUA/MUPs can qualify designated areas and population groups for benefits under the following programs: 

  1. Community Health Centers and Federally Qualified Health Centers
  2. Federally Qualified Health Centers Look-Alike Program
  3. Rural Health Clinic Act - Provides cost-based reimbursement to RHCs for physician services provided under Medicaid and Medicare programs. For certification information visit the DSHS Web site.

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