Covered California's Consolidated Essential Community Provider List

Introduction

Covered California is dedicated to inclusion of Essential Community Providers (ECPs) who serve the low-income and medically underserved communities in provider networks offered by its Qualified Health Plans (QHP). The Federal 340B list of ECPs is a critical category of Essential Community Providers but does not constitute the sole source of such entities. There are some provider organizations that serve the low-income and medically underserved population that are not 340Bs, including some that qualify as Health and Safety Code Section 1204a entities under California law. Covered California's Consolidated ECP list is an attempt to create a single, non-duplicated list of ECPs that potentially could serve Covered California enrollees.

NOTE: This Consolidated List of ECPs is non-exhaustive, subject to change and may be updated or re-issued at a future date. The purpose of this list is to facilitate identification of qualifying ECPs by Qualified Health Plans for contracting purposes.

Current categories of ECPs are listed below and are included in the Consolidated ECP List:

  • 340B entities (clinics, hospitals and other entities) ("340B")
  • California Disproportionate Share Hospitals, defined by the California Department of Health Care Services ("DSH")
  • Federally Qualified Health Centers ("FQHCs")
  • Federally designated 638 Tribal Health Programs and Title V Urban Indian Health Organizations ("Tribal/UI")
  • Providers licensed as "community clinic" or "free clinic" under California Health and Safety Code 1204(a), or is a community or free clinic exempt from licensure under 1206 ("1204a clinics")
  • Providers who qualified for HI-TECH Medi-Cal Electronic Health Record Incentive Program dollars ("Medi-Cal EHR"). These are eligible providers who completed the application process for this federal program, administered by the California Department of Health Care Services, to distribute financial resources to encourage providers to establish electronic medical records.

*There is substantial overlap between the 340B, DSH, FQHC, Tribal/UI and 1204a community clinic lists.

Covered California Draft Consolidated ECP List

Previously, Covered California posted five separate files with the contact information for the ECP entities listed above. In collaboration with ECPs and stakeholders, Covered California staff has worked to develop a draft version of a single consolidated list of California ECPs.

The consolidated ECP list contains four tabs:

  • Notes
  • Hospital ECPs
    • 340B hospitals
    • DSH Hospitals
    • Children’s hospitals
    • County or publicly owned hospitals
  • Non hospital ECPs
    • 340Bs
    • FQHCs
    • Community Clinics
    • Free Clinics
    • Tribal and Urban Indian Clinics
  • Medi-Cal EHR Incentive Program Hi TECH primary care physicians

Please note the following reference lists were used:

  • Federal 340B list was downloaded from HRSA's website on 01-01-2017
  • Disproportionate Share Hospital list obtained from DHCS for Financial Year 2014-2015 obtained 01-01-2017
  • The 1204a list, downloaded from the California Department of Public Health, on 01-01-2017
  • The most current Indian Health Services list, obtained 01-01-2017
  • Public hospital affiliated community clinics from the California Association of Pubic Hospitals dated 01-01-2017

Please refer any questions to ProviderDirectory@Covered.CA.gov. Note "ECP 2017" in the subject line.


Download: Covered California Consolidated ECP List (Excel)