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SERVICE PROVIDER MONTHLY TREATMENT & PROGRESS SUMMARY  Form

SERVICE PROVIDER MONTHLY TREATMENT & PROGRESS SUMMARY Form

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How to Complete the Essential Community  Provider/Network Adequacy (or ECP/NA) Template Issuers seeking to offer  qualified health plans (or QHPs),   including stand-alone dental plans (or  SADPs) on the Federally-facilitated Exchange must submit a completed  QHP Application per CMS guidelines. As part of the QHP certification process,  issuers are asked to fill out several templates   with issuer- and plan-level data. These templates,  along with any supporting documentation submitted,   comprise an issuer’s QHP Application. Among these templates is the Essential   Community Provider/Network Adequacy (or  ECP/NA) Template. An “essential community   provider” or “ECP” is a medical or dental provider  facility that serves predominantly low-income,   medically underserved individuals. In order  to meet ECP requirements, applicants must: 1. Have contracts with at least 35% of  available ECPs in each respective plan’s   service area they cover for each

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