Address
Form of workQualification Requirements
All Temporary/Relief Care Physicians assigned to CDCR 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, Temporary/Relief 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 Temporary/Relief Primary Care Physician will be assigned.
3. Obstetrics/Gynecology – Temporary/Relief 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 Temporary/Relief Primary Care Physician will be assigned.
4. All Temporary/Relief 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. Temporary/Relief 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. Any Temporary/Relief Primary Care Physician providing services through this Agreement must be proficient in the English language and be able to communicate effectively with the CDCR/CCHCS. All Temporary/Relief Primary Care Physicians must be able to speak, understand oral and written communication and write effectively in the English language. Any Temporary/Relief 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 Temporary/Relief 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. Care delivery for Primary Care Telemedicine is remote via teleconferencing equipment and that basic computer competency would be necessary.
A. Standards of Obligation
To assist CDCR/CCHCS in its exercise of its duty to provide and manage medical healthcare services for the patient/youth of the State of California, Temporary/Relief 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. Temporary/Relief Primary Care Physicians shall adhere to the CDCR/CCHCS medical staff by-laws, rules, regulations, policies and procedures, and comply with universal infection control precautions. B. Authorization
1. Authorization for Treatment
Temporary/Relief 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 CDCR/CCHCS Institution/Facility CEO/CME or designee, in accordance with CCHCS's Utilization Management Plan. Temporary/Relief Primary Care Physician shall complete and return all forms required by CDCR 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 CDCR/CCHCS prior authorization form. 2. Authorization for Transportation/Transfers
Temporary/Relief Primary Care Physician shall agree that, as required by law, CDCR/CCHCS retains full authority to determine the manner in which a patient/youth is transported to the CDCR/CCHCS Institutions/Facilities or transferred to other healthcare facilities, after the course of treatment or therapy has been implemented or completed.
Temporary/Relief Primary Care Physician shall not transfer a patient/youth to any Institution/Facility without prior written authorization from the appropriate CDCR/CCHCS Institution/Facility CEO/CME or designee.
3. Experimental and Investigational Drugs and Procedures Temporary/Relief 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 CDCR's Office of Legal Affairs. Temporary/Relief 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. Temporary/Relief 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. Temporary/Relief 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. Temporary/Relief Primary Care Physician shall acknowledge that the appeal must be recognized as medically necessary.
c. The CDCR/CCHCS 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, Temporary/Relief 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, Temporary/Relief 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 CDCR/CCHCS supervisors and direct patient/youth examinations. The Temporary/Relief 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 CDCR/CCHCS's formulary to be kept on file by the Temporary/Relief Primary Care Physician. Temporary/Relief Primary Care Physician shall consult with CDCR physicians to assure that whenever possible only those medications which are on the CDCR's formulary are prescribed unless prior authorization is given by the Institution/Facility's CEO/CME
All Temporary/Relief Care Physicians assigned to CDCR 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, Temporary/Relief 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 Temporary/Relief Primary Care Physician will be assigned.
3. Obstetrics/Gynecology – Temporary/Relief 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 Temporary/Relief Primary Care Physician will be assigned.
4. All Temporary/Relief 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. Temporary/Relief 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. Any Temporary/Relief Primary Care Physician providing services through this Agreement must be proficient in the English language and be able to communicate effectively with the CDCR/CCHCS. All Temporary/Relief Primary Care Physicians must be able to speak, understand oral and written communication and write effectively in the English language. Any Temporary/Relief 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 Temporary/Relief 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. Care delivery for Primary Care Telemedicine is remote via teleconferencing equipment and that basic computer competency would be necessary.
A. Standards of Obligation
To assist CDCR/CCHCS in its exercise of its duty to provide and manage medical healthcare services for the patient/youth of the State of California, Temporary/Relief 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. Temporary/Relief Primary Care Physicians shall adhere to the CDCR/CCHCS medical staff by-laws, rules, regulations, policies and procedures, and comply with universal infection control precautions. B. Authorization
1. Authorization for Treatment
Temporary/Relief 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 CDCR/CCHCS Institution/Facility CEO/CME or designee, in accordance with CCHCS's Utilization Management Plan. Temporary/Relief Primary Care Physician shall complete and return all forms required by CDCR 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 CDCR/CCHCS prior authorization form. 2. Authorization for Transportation/Transfers
Temporary/Relief Primary Care Physician shall agree that, as required by law, CDCR/CCHCS retains full authority to determine the manner in which a patient/youth is transported to the CDCR/CCHCS Institutions/Facilities or transferred to other healthcare facilities, after the course of treatment or therapy has been implemented or completed.
Temporary/Relief Primary Care Physician shall not transfer a patient/youth to any Institution/Facility without prior written authorization from the appropriate CDCR/CCHCS Institution/Facility CEO/CME or designee.
3. Experimental and Investigational Drugs and Procedures Temporary/Relief 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 CDCR's Office of Legal Affairs. Temporary/Relief 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. Temporary/Relief 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. Temporary/Relief 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. Temporary/Relief Primary Care Physician shall acknowledge that the appeal must be recognized as medically necessary.
c. The CDCR/CCHCS 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, Temporary/Relief 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, Temporary/Relief 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 CDCR/CCHCS supervisors and direct patient/youth examinations. The Temporary/Relief 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 CDCR/CCHCS's formulary to be kept on file by the Temporary/Relief Primary Care Physician. Temporary/Relief Primary Care Physician shall consult with CDCR physicians to assure that whenever possible only those medications which are on the CDCR's formulary are prescribed unless prior authorization is given by the Institution/Facility's CEO/CME
