354.652. Designation as essential community provider, procedure, qualifications.
Designation as essential community provider, procedure,qualifications.
354.652. Any physician seeking a designation as an essential communityprovider shall:
(1) Apply to the director of the department;
(2) Document to the department that at least forty percent of thephysician's practice is comprised of:
(a) Medicaid or uninsured patients, or both; or
(b) A combination of paragraph (a) and Medicare or underinsuredpatients, or both;
(3) Serve a medically underserved area or a health professional shortagearea;
(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 andweekends at a principal site;
(7) Hold hospital staff privileges with a participating network hospitalof the health care insurer;
(8) Not be a direct employee of a health care insurer, a for profit or anot-for-profit hospital or health services corporation; and
(9) Meet the following quality standards in accordance with guidelinesestablished by the National Committee for Quality Assurance:
(a) A current valid license to practice;
(b) Clinical privileges in good standing at the hospital designated bythe physician as the primary admitting facility;
(c) A valid Drug Enforcement Agency or Controlled Dangerous Substancescertificate, if applicable;
(d) Graduation from medical school, and completion of a residency orboard certification if applicable;
(e) Work history;
(f) Current adequate malpractice insurance according to the managed careorganization's policy; and
(g) Professional liability claims history.
(L. 1998 H.B. 1302 § 2)