HomeMy WebLinkAboutMINUTES - 02052013 - C.87RECOMMENDATION(S):
Approve the list of providers recommended by the Contra Costa Health Plan's Medical Director on November 13,
2012 and December 21, 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: 02/05/2013 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, District I
Supervisor
Candace Andersen, District II
Supervisor
Karen Mitchoff, District IV
Supervisor
Federal D. Glover, District V
Supervisor
ABSENT:Mary N. Piepho, District III
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: February 5, 2013
David Twa, County Administrator and Clerk of the Board of Supervisors
By: Carrie Del Bonta, Deputy
cc: T Scott, D Gary, L Maria Perez
C. 87
To:Board of Supervisors
From:William Walker, M.D.
Date:February 5, 2013
Contra
Costa
County
Subject:Approve New and Recredentialing Providers in Contra Costa Health Plan’s Community Provider Network
CHILDREN'S IMPACT STATEMENT:
None.
ATTACHMENTS
G:\NON CONTRACTS\bopl-December 21, 2012.doc
G:\NON CONTRACTS\bopl-November 13, 2012.doc
Page 1 of 2
Contra Costa Health Plan
Providers Approved by Medical Director
December 21, 2012
CREDENTIALING PROVIDERS DECEMBER 2012
Name Specialty
Adamich, Jessica, PA Mid-Level
Orthopaedic Surgery Assistant
Edmunds, Magdalen, M.D. Primary Care
Family Medicine
Karamlou, Kasra, M.D. Hematology/Oncology
Rahman, Sophia, M.D. Radiation/Oncology
Rajagopalan, Vandana, M.D. Hematology/Oncology
Reddy, Srikanth, M.D. Hematology/Oncology
Sandeman, Joshua, N.P. Primary Care
Toth, John, DO Undersea &
Hyperbaric Medicine
Woods, Marisa, N.P. Primary Care
Family Medicine
Zeichner, Lindsay, M.D. Primary Care
Family Medicine
RECREDENTIALING PROVIDERS DECEMBER 2012
Name Specialty
Cardoza, Mary, M.D. Surgery - General
Carolla, Michael, MFT Mental Health Services
Chinn, Daniel, M.D. Radiation Oncology
Christian, Darrell, Ph.D. Mental Health Services
Cogen, Lorna, M.D. Surgery - General
Cook, Alison, DPM Podiatry
Deboisblanc, Michael, M.D. Surgery – General Vascular
Glickman, Bobby, M.D. Surgery - General
Gollapudi, Ramakrishna, M.D. Gastroenterology
Gong, Henry, M.D. Cardiovascular Disease
Haynes, Gwendolyn, CNM Midwife
Hsu, Hsien-Wen, M.D. Pulmonary Disease
Jacka, Ciaran, DPM Podiatry
Jeiven, Susan, M.D. Pediatric Gastroenterology
Johnson, Eric, M.D. Cardiovascular Disease
Kerenyi, Victor, DC Chiropractic Medicine
Kumar, Harmesh, Ph.D. Mental Health Services
LeNoir, Denise, N.P. Primary Care
Pediatrics/Allergy & Immunology
Contra Costa Health Plan
Providers Approved by Medical Director
December 21, 2012
Page 2 of 2
Liao, Richard, L.Ac. Acupuncture
Moy, Jason, M.D. Surgery - General
Murray, Dwight, Ph.D. Mental Health Services
Nassiri, Massoud, DC Chiropractic Medicine
Pennington-Kent, Phyllis, Ph.D. Mental Health Services
Polido, Phillip, M.D. Surgery - General
Steinberg, Jonathan, DPM Podiatry
Stern, Jeffrey, M.D. Gynecologic Oncology
Xue, Chulong, L.Ac. Acupuncture
CREDENTIALING ORGANIZATIONAL PROVIDERS
DECEMBER 2012
Provider Name
Provide the Following
Services
Location
Manor Care of Walnut Creek CA,
LLC
dba: Manorcare Health Services –
Walnut Creek
Skilled Nursing Facility Walnut Creek
Odyssey Healthcare Operating A, LP
dba: Odyssey Hospice
Hospice Alameda
Rheem Valley Healthcare, LLC
dba: Rheem Valley Convalescent
Hospital
Skilled Nursing Facility Moraga
RECREDENTIALING ORGANIZATIONAL PROVIDERS
DECEMBER 2012
Provider Name
Provide the Following
Services
Location
RAI Care Centers of Northern
California II, LLC
dba: RAI-Telegraph-Piedmont
Dialysis Oakland
RAI Care Centers of Oakland II,
LLC
dba: RAI-East Bay-Oakland
Dialysis Oakland
bopl-December 21, 2012
Contra Costa Health Plan
Providers Approved by Peer Review and Credentialing Committee
November 13, 2012
CREDENTIALING PROVIDERS NOVEMBER 2012
Name Specialty
Breaux, Barry, M.D. Ophthalmology
Fieser, Carl, M.D. Physical Medicine and Rehabilitation/
Pain Management
Sultan, Sultan, M.D. Primary Care
Internal Medicine
Zarghami, Angeline, N.P. Mid-level
Family Planning
RECREDENTIALING PROVIDERS NOVEMBER 2012
Name Specialty
Barakeh, Joseph, D.O. Ophthalmology
Batten, Kristine, M.D. Cardiovascular Disease
Chan, Lina, O.D. Optometry
Coleman, Deborah, CNM Midwife
Devane, Matthew, DO Cardiovascular Disease
Hochstatter, Jeanette, O.D. Optometry
Kashkin, Karen, M.D. Family Planning
Krouse, John, M.D. Cardiovascular Disease
Matin, Bita, DDS Dentist
Meyerhoff, Jessamyn, LM Midwife
Pham, An T., M.D. Primary Care
Pediatrician
Port, Bryan, Psy.D. Mental Health Services
Ruzicano, Raymond, M.D. Psychiatry
Schaefer, Robert, DC Chiropractic Medicine
Schoenwald, Phyllis, PA Mid-Level
Family Planning
Seslar, Jon-Paul, DPM Podiatry
Shah, Samir, M.D. Ophthalmology
Shih, Grace, M.D. Family Planning
Sidhu, Pramodh, M.D. Cardiovascular Disease
Sivesind, Elizabeth, PA Mid-Level
OB/GYN
Veal, Ulanda, M.D. Primary Care
Pediatrician
Wulff, Christopher, M.D. Cardiovascular Disease
Contra Costa Health Plan
Providers Approved by Peer Review and Credentialing Committee
November 13, 2012
Page 2 of 2
CREDENTIALING ORGANIZATIONAL PROVIDER
NOVEMBER 2012
Provider Name
Provide the Following
Services
Location
Maxim Healthcare Services, Inc.
dba: Maxim Healthcare Services,
Inc.
Home Health Emeryville
RECREDENTIALING ORGANIZATIONAL PROVIDER
NOVEMBER 2012
Provider Name
Provide the Following
Services
Location
Windsor Convalescent and
Rehabilitation Center of Concord,
LLC
dba: Windsor Manor Rehabilitation
Center of Concord
Skilled Nursing Facility Concord
bopl-November 13, 2012