Title: Section 47-2.2 - Practice requirements/eligibility

47-2.2 Practice requirements/eligibility.

(a) A new pediatric practitioner may be eligible to contract with the Program if the practitioner:

(1) agrees to provide pediatric services full-time in a designated pediatric area;

(2) agrees that the ratio of the practice's target patient population to the total patient population will be equal to or greater than the ratio of the target population in the designated area to the total population in that designated area;

(3) agrees to provide medical care in accordance with accepted medical standards (for example, standards accepted by the American College of Pediatricians);

(4) has the education, training and access to health care facilities to provide pediatric services to the eligible population (or, for a pediatric nurse practitioner, a practice arrangement with a pediatric practitioner who meets such requirements) including:

(i) hospital admitting privileges;

(ii) arrangements for twenty-four hour backup coverage; and

(iii) has purchased medical malpractice insurance from a medical liability insurer; and

(5) is responsible for paying his/her own malpractice insurance premiums or is a member of a partnership or professional corporation which is responsible for paying his/her malpractice insurance premiums.

(b) An additional service obstetric practitioner may be eligible to contract with the Program if the practitioner:

(1) agrees to increase the number of the target population provided comprehensive obstetrical services over the number served preceding the application;

(2) agrees to provide medical care in accordance with accepted medical standards (for example, standards accepted by the American College of Obstetricians and Gynecologists, the American Academy of Family Practitioners, or the American College of Nurse- Midwives);

(3) has the education, training and access to health care facilities to provide obstetric services to the eligible population (or, for obstetric nurse practitioners, a practice arrangement with an obstetric practitioner who meets such requirements) including:

(i) hospital admitting and delivery privileges in a hospital with maternity services or practice privileges in a birth center; and

(ii) arrangements for twenty-four hour backup coverage; and

(iii) has purchased medical malpractice insurance from a medical liability insurer; and

(4) is responsible for paying his/her/their own malpractice insurance premiums or is a member of a partnership or professional corporation which is responsible for paying his/her malpractice insurance premiums.

(c) A disproportionate share obstetric practitioner may be eligible to contract with the Program if the practitioner:

(1) agrees to maintain his/her/their current high number of the target population provided comprehensive obstetrical services: the number of deliveries required to be performed to be considered a group providing a disproportionate share of services is the sum of those required for each individual to be a disproportionate share provider;

(2) agrees to provide medical care in accordance with accepted medical standards (for example, standards accepted by the American College of Obstetricians and Gynecologists, the American Academy of Family Practitioners, or the American College of Nurse- Midwives);

(3) has the education, training and access to health care facilities to provide obstetric services to the eligible population (or for obstetric nurse practitioners, a practice arrangement with an obstetric practitioner who meets such requirements) including:

(i) hospital admitting and delivery privileges in a hospital with maternity services or practice privileges in a birth center;

(ii) arrangements for twenty-four hour backup coverage; and

(iii) has purchased medical malpractice insurance from a medical liability insurer; and

(4) is responsible for paying his/her/their own malpractice insurance premiums or is a member of a partnership or professional corporation which is responsible for paying his/her/their malpractice insurance premiums.