354.652. Designation as essential community provider, procedure, qualifications.

248 words·~1 min read·/mo/chapter-354/354-652

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

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.

--------

(L. 1998 H.B. 1302 § 2)