HomeMy WebLinkAboutMINUTES - 08212012 - C.60RECOMMENDATION(S):
Approve the list of providers recommended by the Contra Costa Health Plan's Medical Director on June 12, 2012,
June 19, 2012 and July 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: 08/21/2012 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, District I Supervisor
Candace Andersen, District II
Supervisor
Mary N. Piepho, District III
Supervisor
Karen Mitchoff, District IV
Supervisor
Federal D. Glover, District V
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 21, 2012
David Twa, County Administrator and Clerk of the Board of Supervisors
By: Carrie Del Bonta, Deputy
cc: Tasha Scott, Demetria Gary, L. Maria Perez
C. 60
To:Board of Supervisors
From:William Walker, M.D., Health Services Director
Date:August 21, 2012
Contra
Costa
County
Subject:Approve New and Recredentialing Providers and New Organizational Provider in Contra Costa Health Plan’s
Community Provider Network
CHILDREN'S IMPACT STATEMENT:
Not applicable.
ATTACHMENTS
G:\NON CONTRACTS\Sorted by year\2012\bopl-June 12, 2012.doc
G:\NON CONTRACTS\Sorted by year\2012\bopl-June 19, 2012.doc
G:\NON CONTRACTS\Sorted by year\2012\bopl-July 31, 2012.doc
Page 1 of 2
Contra Costa Health Plan
Providers Approved by Peer Review and Credentialing Committee
June 12, 2012
CREDENTIALING PROVIDERS JUNE 2012
Name Specialty
Bitar, David, M.D. Surgery – Colon and Rectal
Clark-Raby, Kimberlee, N.P.
Mid-level –
Pain Management
Van Handel, Mark, M.D. Neurology
RECREDENTIALING PROVIDERS JUNE 2012
Name Specialty
Barker, Dennis, DC Chiropractic
Cartwright, Wade, M.D. Otolaryngology
(ENT)
Cheng, Hsiu-Li, CNM Midwife
Copping, Russell, DC Chiropractic
Curzi, Mario, M.D. Nephrology
Davies, Robert, M.D. Nephrology
Diraimondo, Carol, M.D. Nephrology
Drager, Sharon, M.D. Surgery – Vascular
Faulkner, Mary, N.P. Mid-level – OB/GYN
Keim, Valerie, MFT Mental Health Services
Lin, David, M.D. Gastroenterology
Mouratoff, John, M.D. Nephrology
Nezami, Robert, M.D. Psychiatry
Schick, Kirsten, DC Chiropractic
Schick, Robert, DC Chiropractic
Severin, Todd, M.D. Ophthalmology
Sheppard, Barry, M.D. Surgery – Thoracic Cardiovascular
Weiss, Jonathan, M.D. Perinatology
Contra Costa Health Plan
Providers Approved by Peer Review and Credentialing Committee
June 12, 2012
Page 2 of 2
CREDENTIALING ORGANIZATIONAL PROVIDERS
JUNE 2012
Provider Name
Provide the Following
Services
Location
Alzheimer’s Services of The East
Bay, Inc.
dba: Alzheimer’s Services of The
East Bay – Berkeley
Adult Day Health Care Berkeley
DaVita – DVA Healthcare Renal
Care, Inc.
dba: Oakland Dialysis
Dialysis Oakland
DaVita - DVA Renal Healthcare, Inc.
dba: Benicia Dialysis
Dialysis Benicia
DaVita - Total Renal Care, Inc.
dba: Hayward Dialysis Center
Dialysis Hayward
DaVita – Total Renal Care, Inc.
dba: Pleasanton Dialysis Center
Dialysis Pleasanton
DaVita – Total Renal Care, Inc.
dba: TRC Antioch Dialysis Center
Dialysis Antioch
bopl-June 12, 2012
Contra Costa Health Plan
Provider Approved by Medical Director
June 19, 2012
RECREDENTIALING PROVIDER JUNE 2012
Name Specialty
Tebben, Josie, M.D.
Nephrology
bopl-June 19, 2012
Contra Costa Health Plan
Providers Approved by Medical Director
July 31, 2012
CREDENTIALING PROVIDERS JULY 2012
Name Specialty
Chin, Jonathan, M.D. Urology
Danko, Angela, N.P. Mid-Level
Pain Management
Fernandes, Robin, N.P. Mid-Level
Hematology & Medical Oncology
Makedonsky, Michael, O.D. Optometry
Marzioli, Joanne, MFT Mental Health Services
Raffetto, Katherine, N.P. Mid-Level
Family Planning
Ramirez, Veronica, N.P. Mid-Level
HIV/Aids
Sutton, Michael, O.D. Optometry
Yang, Dan, M.D. Mental Health Services
RECREDENTIALING PROVIDERS JULY 2012
Name Specialty
Aslan, Alex, M.D. Gastroenterology
Brandeis, Judson, M.D. Urology
Burton, John, M.D. Surgery – Orthopaedic
Cipolla, Gail, N.P. Mid-Level
Family Planning
Cohen, Aaron Scott, DDS Endodontics
Djang-Estill, Flore, N.P. Mid-Level
Family Planning
Fanucchi, Joanne, L.Ac. Acupuncture
Hay, Donald, M.D. Urology
Helms, Ileana, M.D. Nephrology
Hopkins, Brian, M.D. Urology
Hwang, Ivan, M.D. Ophthalmology
Joseph, Michal, Aud. Hearing Aid Dispensing
Lieb, Jeremy, M.D. Urology
Livermore, Norman, M.D. Surgery – Orthopaedic
Nagel, Charlotte, M.D. Ophthalmology
Contra Costa Health Plan
Providers Approved by Medical Director
July 31, 2012
Page 2 of 2
RECREDENTIALING PROVIDERS JULY 2012
Name Specialty
Pascualy, Julie, P.A. Mid-Level
Family Planning
Rios, Ena, LCSW Mental Health Services
Roberts, Brandon, DC Chiropractic
Rosenberg, Jacob, M.D. Pain Management
Savage, David, DC Chiropractic
Sethi, Parminder, M.D. Urology
Sklar, Abraham, M.D. Family Planning
Stoddard, Fred, M.D. Mental Health Services
Taylor, Stephen, M.D. Urology
Vastine, David, M.D. Ophthalmology
Waldman, Jeffrey, M.D. Family Planning
Wang-Chen, Connie, O.D. Optometry
Williams, Edward, O.D. Optometry
CREDENTIALING ORGANIZATIONAL PROVIDER
JULY 2012
Provider Name
Provide the Following
Services
Location
DaVita – Total Renal Care, Inc.
dba: TRC East Bay PD
Dialysis San Leandro
bopl-July 31, 2012