Section 354.652

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS

Chapter 354

Effective - 28 Aug 1998   

  354.652.  Designation as essential community provider, procedure, qualifications. — Any physician seeking a designation as an essential community provider shall:

  (1)  Apply to the director of the department;

  (2)  Document to the department that at least forty percent of the physician's practice is comprised of:

  (a)  Medicaid or uninsured patients, or both; or

  (b)  A combination of paragraph (a) and Medicare or underinsured patients, or both;

  (3)  Serve a medically underserved area or a health professional shortage area;

  (4)  Serve a medically underserved population;

  (5)  Spend at least twenty hours per week at a principal site;

  (6)  Be available to a medically underserved population on evenings and weekends at a principal site;

  (7)  Hold hospital staff privileges with a participating network hospital of the health care insurer;

  (8)  Not be a direct employee of a health care insurer, a for-profit or a not-for-profit hospital or health services corporation; and

  (9)  Meet the following quality standards in accordance with guidelines established by the National Committee for Quality Assurance:

  (a)  A current valid license to practice;

  (b)  Clinical privileges in good standing at the hospital designated by the physician as the primary admitting facility;

  (c)  A valid Drug Enforcement Agency or Controlled Dangerous Substances certificate, if applicable;

  (d)  Graduation from medical school, and completion of a residency or board certification if applicable;

  (e)  Work history;

  (f)  Current adequate malpractice insurance according to the managed care organization's policy; and

  (g)  Professional liability claims history.

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(L. 1998 H.B. 1302 § 2)