HomeMy WebLinkAboutMINUTES - 08142012 - C.78RECOMMENDATION(S):
Approve the list of providers recommended by the Contra Costa Health Plan's Medical Director on May 31, 2012,
and by the Health Services Director, as required by the State Departments of Health Care Services and Managed
Health Care, and the Centers for Medicare and Medicaid Services.
FISCAL IMPACT:
None.
BACKGROUND:
The National Committee on Quality Assurance (NCQA) has requested evidence of Board of Supervisors approval
for each CCHP provider be contained within the provider’s credentials file.
The recommendations were made by CCHP’s Medical Director.
CONSEQUENCE OF NEGATIVE ACTION:
If this action is not approved, Contra Costa Health Plan's Providers would not be appropriately credentialed and not
be in compliance with the NCQA.
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
Action of Board On: 08/14/2012 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:Candace Andersen, District II
Supervisor
Mary N. Piepho, District III
Supervisor
Karen Mitchoff, District IV
Supervisor
Federal D. Glover, District V
Supervisor
ABSENT:John Gioia, District I
Supervisor
Contact: Patricia Tanquary, 313-6004
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the
Board of Supervisors on the date shown.
ATTESTED: August 14, 2012
David Twa, County Administrator and Clerk of the Board of Supervisors
By: STACEY M. BOYD, Deputy
cc: Tasha Scott, Demetria Gary, L. Maria Perez
C. 78
To:Board of Supervisors
From:William Walker, M.D., Health Services Director
Date:August 14, 2012
Contra
Costa
County
Subject:APPROVE New and Recredentialing Providers and New and Recredentialing Organizational Providers in Contra
Costa Health Plan’s Provider Network
CHILDREN'S IMPACT STATEMENT:
Not applicable.
ATTACHMENTS
G:\NON CONTRACTS\Sorted by year\2012\~9141560.doc
Contra Costa Health Plan
Providers Approved by Medical Director
May 31, 2012
CREDENTIALING PROVIDERS MAY 2012
Name Specialty
Anand, Shilpi, M.D. Allergy & Immunology
Cardoso, Kimberly, CNM Midwife
Garrehy, Bridget, PA Mid-Level
Orthopaedic Surgery Assistant
Nguyen, Tung, OD Optometry
Saldivar, Nancy, N.P. Mid-Level
Family Planning
Sherbondy, Angela, PA Mid-Level
Orthopaedic Surgery Assistant
Tsai, Linda, D.O. Primary Care
Family Medicine
RECREDENTIALING PROVIDERS MAY 2012
Name Specialty
Bansal, Raghunath, M.D. Mental Health Services
Belzer, Kathleen, CNM Midwife
Bernett, Jorge, M.D. Infectious Disease/
HIV/Aids
Blaisch, Brian, M.D. Primary Care
Pediatrician
Bui, Thanh, M.D. Primary Care
Family Medicine
Chen, Henry, M.D. Cardiovascular Disease
Chen, William, M.D. Primary Care
Internal Medicine/
Allergy & Immunology
Chin, Daniel, OD Optometry
Corona, Mario, M.D. Nephrology
DuMouchel, Ralph, DC Chiropractic
Hill, David, M.D. Cardiovascular Disease
Jones, Mark, OD Optometry
Kilborn, Debora, N.P. Mid-Level
Cardiovascular Disease
Contra Costa Health Plan
Providers Approved by Medical Director
May 31, 2012
Page 2 of 3
RECREDENTIALING PROVIDERS MAY 2012
Name Specialty
Lord, Janet, M.D. Pediatrics/ Physical Medicine &
Rehabilitation
Milano, John, DC Chiropractic
Paterson, Bruce, M.D. Allergy & Immunology
Paul, T. Otis, M.D. Ophthalmology
Pleet, Helaine, M.D. Primary Care
Pediatrician
Watson, Carl, M.D. OB/GYN - Family Planning
Wright, Paul, M.D. OB/GYN - Family Planning
CREDENTIALING ORGANIZATIONAL PROVIDERS
MAY 2012
Provider Name
Provide the Following
Services
Location
DaVita – DVA Healthcare Renal
Care, Inc.
dba: Berkeley Dialysis
Dialysis Berkeley
DaVita – DVA Renal Healthcare,
Inc.
dba: Alameda County Dialysis
Dialysis Oakland
DaVita – Llano Dialysis, LLC
dba: El Cerrito Dialysis
Dialysis El Cerrito
DaVita – Llano Dialysis, LLC
dba: Oakland Peritoneal Dialysis
Center
Dialysis Oakland
DaVita – Llano Dialysis, LLC
dba: San Pablo Dialysis
Dialysis San Pablo
DaVita – Stewart Dialysis, LLC
dba: Richmond Dialysis
Dialysis Richmond
Contra Costa Health Plan
Providers Approved by Medical Director
May 31, 2012
Page 3 of 3
CREDENTIALING ORGANIZATIONAL PROVIDERS
MAY 2012
Provider Name
Provide the Following
Services
Location
. DaVita - Total Renal Care, Inc.
dba: TRC Union City Dialysis
Center
Dialysis Union City
DaVita – Walker Dialysis, LLC
dba: Fremont Home Training
Dialysis Fremont
DaVita – Walker Dialysis, LLC
dba: Hayward Mission Hills Dialysis
Dialysis Hayward
Guardian Adult Day Health Centers
of California
dba: Guardian Adult Day Health
Center
Adult Day Services El Sobrante
Rehabilitation Services of Northern
California
dba: Mt. Diablo Center for Adult
Day Health Care
Adult Day Services Pleasant Hill
Rehabilitation Services of Northern
California
dba: The Bedford Center
Adult Day Services Antioch
RECREDENTIALING ORGANIZATIONAL PROVIDER
MAY 2012
Provider Name
Provide the Following
Services
Location
San Jose Dental Surgery Center, Inc.
dba: San Jose Dental Surgery Center
Outpatient Dental
Surgery
San Jose
bopl-May 31, 2012