09/18/2015
Now Hiring All Care Physicians Statewide
Qualification Requirements
JOB DESCRIPTION
All Care Physicians assigned must have the minimum experience outlined below:
1. Twelve (12) continuous months of experience within the last three (3) years performing services similar in scope to those defined herein in a public or private institution.
2. Specialty Services – In addition to the above requirements, Primary Care Physicians who are requested to work in a specialized area such as emergency medicine, surgery, etc., shall also have at least two (2) years of experience within the last three (3) years providing patient care within that setting and possess any required certificates. Clinical competencies must be current and validated for the area in which Primary Care Physician will be assigned.
3. Obstetrics/Gynecology – Primary Care Physicians provided to female Institutions/Facilities must also have at least one (1) year of experience within the last five (5) years rendering obstetric and gynecological nursing or patient care services in a healthcare setting in addition to the above qualifications. Clinical competencies must be current and validated for the area in which Primary Care Physician will be assigned.
4. All Primary Care Physicians shall licensed to practice medicine in the State of California as defined in the Medical Practice Act, Chapter 5, commencing with Section 2000 of the Business and Professions Code and possess a valid Physician license as issued by the Medical Board/Osteopathic Board of California. Primary Care Physician must be a Medical Doctor or Doctor of Osteopathy (M.D./D.O.), Board Certified, maintain Advanced Cardiovascular Life Support (ACLS) certification, maintain current Drug Enforcement Administration (DEA) Certification and maintain active CCHCS credentialing status.
5. A Fictitious Name Permit (FNP) must be on file with the California Department of Consumer Affairs under the name of the Medical Corporation being used, as specified in the Medical Practice Act, Chapter 5, commencing with Section 2000 of the Business and Professions Code.of the Business and Professions Code.
6. Business and Profession Code 2072
Notwithstanding any other provision of law and subject to the provisions of the State Civil Service Act, any person who is licensed to practice medicine in any other state, who meets the requirements for application set forth in this chapter and who registers with and is approved by the Division of Licensing may be appointed to the medical staff within a state institution and, under the supervision of a physician and surgeon licensed in this state, may engage in the practice of medicine on persons under the jurisdiction of any state institution. Qualified physicians and surgeons licensed in this state shall not be recruited pursuant to this section. No person appointed pursuant to this section shall be employed in any state institution for a period in excess of two years from the date the person was first employed and the appointment shall not be extended beyond the two-year period. At the end of the two-year period, the physician shall have been issued a physician’s and surgeon’s certificate by the board in order to continue employment. Until the physician has obtained a physician’s and surgeon’s certificate from the board, he or she shall not engage in the practice of medicine in this state except to the extent expressly permitted herein.
7. Any Primary Care Physician providing services through this Agreement must be proficient in the English language and be able to communicate effectively with the facility. All Primary Care Physicians must be able to speak, understand oral and written communication and write effectively in the English language. Any Primary Care Physician who fails to meet the minimum qualifications shall not be permitted to perform services.
Service Delivery Requirements
Under the direction of the Institution/Facility CEO/CME or designee, the Primary Care Physician shall provide services as permitted within the scope of practice for Primary Care Physician services in accordance with Institution/Facility policies and procedures.
A. Standards of Obligation
To assist the facility in its exercise of its duty to provide and manage medical healthcare services for the patient/youth of the State of California, Primary Care Physicians shall provide high quality services, consistent with the terms and conditions under this Agreement and consistent with established and commonly accepted standards and principles of medical practice. Nothing in this Agreement shall supersede the common law rules for the interpretation of established and commonly accepted standards and principles of medical practice.
Primary Care Physicians shall adhere to the medical staff by-laws, rules, regulations, policies and procedures, and comply with universal infection control precautions.
B. Authorization
1. Authorization for Treatment
Primary Care Physician shall agree that, as required by law, excluding emergency and primary care services, prior authorization must be obtained in writing from the respective Institution/Facility CEO/CME or designee, in accordance with Utilization Management Plan. Primary Care Physician shall complete and return all forms required regarding treatment of patient/youth. Authorization must be documented in the patient/youth medical record in all cases of essential services before considering any non-emergency specialty treatment, or any consultations by specialty Physicians, Physician Assistants, and/or Nurse Practitioners or diagnostic procedures not specifically stated in a prior authorization form.
2. Authorization for Transportation/Transfers
Primary Care Physician shall agree that, as required by law, retains full authority to determine the manner in which a patient/youth is transported to the Institutions/Facilities or transferred to other healthcare facilities, after the course of treatment or therapy has been implemented or completed.
Primary Care Physician shall not transfer a patient/youth to any Institution/Facility without prior written authorization from the appropriate Institution/Facility CEO/CME or designee.
3. Experimental and Investigational Drugs and Procedures
Primary Care Physician shall not perform on or administer to any patient/youth any experimental or investigational treatment, therapy, procedure or drug. Such treatment, unless it is otherwise permissible under law, is prohibited under Penal Code, Section 3502, and thus, must have prior authorization by the Institution/Facility CEO/CME or designee and Office of Legal Affairs. Primary Care Physician shall agree to perform or administer only those medical services which are recognized as being in accord with generally accepted professional medical standards, or as being safe and effective for use in the treatment of an illness, injury or condition at issue, subject to the limitations described in this Agreement.
4. Exclusions and Limitations
a. Primary Care Physician shall agree that no healthcare service or treatment shall be provided for those conditions specifically listed in California Code of Regulations (CCR), Title 15, Division 3, Chapter 1, Subchapter 4, Article 8, Section 3350.1. Physicians provided by the Vendor may request individual case exceptions for excluded or limited healthcare service or treatment by seeking prior approval of the Institution/Facility's CEO/CME or designee.
b. Primary Care Physician agree that any excluded healthcare service or treatment needed for pre-existing conditions shall be provided only in the event that the condition has become aggravated in such a manner that it poses a significant threat to the patient's/youth's current health and if not treated would result in morbidity and/or mortality. Primary Care Physician shall acknowledge that the appeal must be recognized as medically necessary.
c. The Medical Standards of Care shall be used as a reference when prior authorization is granted.
5. Clinical Reviews
At the request of the Institution/Facility's CEO/CME or designee, Primary Care Physician shall perform clinical reviews to determine the quality of clinical care delivered. This includes clinical reviews of index cases (deaths, adverse outcomes etc.) for the purposes of determining clinical quality. As part of the clinical review process, Primary Care Physician can also be required to participate in Professional Practice Committee activities and may be called as witnesses in Professional Practice activities. The process of clinical reviews may include the examination of written health records, discussion with Physicians, Physician Assistants, and/or Nurse Practitioners and supervisors and direct patient/youth examinations. The Primary Care Physicians who perform clinical reviews are required to be skilled in the preparation of written clinical review documents.
6. CCHCS shall provide a copy of the formulary to be kept on file by the Primary Care Physician. Primary Care Physician shall consult with physicians to assure that whenever possible only those medications which are on the formulary are prescribed unless prior authorization is given by the Institution/Facility's CEO/CME or designee for deviation.
