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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