Missouri Laws 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;

Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
following: when used by way of reference to any section of the statutes, mean the section next preceding or next following that in which the reference is made, unless some other section is expressly designated in the reference. See Missouri Laws 1.020

(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;

(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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