Current with changes from the 2024 Legislative Session
Section 354.652 - Designation as essential community provider, procedure, qualificationsAny 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;(f) Current adequate malpractice insurance according to the managed care organization's policy; and(g) Professional liability claims history.