HomeMy WebLinkAboutMINUTES - 09102013 - C.138RECOMMENDATION(S):
Approve the lists of providers recommended by the Contra Costa Health Plan's Peer Review and Credentialing
Committee at their June 18, 2013, July 9, 2013 and August 13, 2013 meetings, 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 Peer Review and Credentialing Committee.
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: 09/10/2013 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
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: September 10, 2013
David Twa, County Administrator and Clerk of the Board of Supervisors
By: Stephanie Mello, Deputy
cc: L. Maria Perez, T Scott, D Gary
C.138
To:Board of Supervisors
From:William Walker, M.D., Health Services Director
Date:September 10, 2013
Contra
Costa
County
Subject:Approve New and Recredentialing Providers in Contra Costa Health Plan’s Community Provider Network
CHILDREN'S IMPACT STATEMENT:
Not applicable.
ATTACHMENTS
June Providers
July Providers
August Providers
Contra Costa Health Plan
Providers Approved by Peer Review and Credentialing Committee
August 13, 2013
CREDENTIALING PROVIDERS AUGUST 2013
Name Specialty
Adler-McDonald, Sarah, N.P.Primary Care
Family Medicine
Fucanan, Maria, N.P.Mid-Level
Oncology
Gordon, Amy, M.D.Primary Care
Family Medicine
Sun, Chao, M.D.Primary Care
Family Medicine
Vijayan, Tara, M.D.HIV/Aids
Wu, David P., M.D.Oncology
RECREDENTIALING PROVIDERS AUGUST 2013
Name Specialty
Davenport, Mary, M.D.OB/GYN
Kang, Steven, M.D.Cardiovascular Disease
Linder, Eileen, O.D.Optometry
Lottman, Karen, LCSW Mental Health Services
Lyon, William, M.D.Orthopaedic Surgery
Mahdavi, Abbas, M.D.Primary Care
Pediatrician
Stephens, Marlene, MFT Mental Health Services
Swope, Brian, M.D.Primary Care
Pediatrician
Vu, John, M.D.Cardiovascular Disease/
Interventional Cardiology
CREDENTIALING ORGANIZATIONAL PROVIDER
AUGUST 2013
Provider Name Provide the Following
Services
Location
RAI Care Centers of Southern
California I, LLC
dba: RAI South Brand San Fernando
Dialysis San Fernando
Contra Costa Health Plan
Providers Approved by Peer Review and Credentialing Committee
August 13, 2013
Page 2 of 2
RECREDENTIALING ORGANIZATIONAL PROVIDERS
AUGUST 2013
Provider Name Provide the Following
Services
Location
Manor Care-Tice Valley CA, LLC
dba: ManorCare Health Services-
Tice Valley #381
Skilled Nursing Facility Walnut Creek
Shields Nursing Centers, Inc.
dba: Shields Nursing Center
Skilled Nursing Facility El Cerrito
Shields Nursing Centers, Inc.
dba: Shields/Richmond Nursing
Center
Skilled Nursing Facility Richmond
bopl-August 13, 2013
Contra Costa Health Plan
Providers Approved by Medical Director
June 18, 2013
CREDENTIALING PROVIDERS JUNE 2013
Name Specialty
Cummings, Patricia, PsyD Mental Health Services
Jang, Jessica, N.P.Mid-Level
Pain Management
Munich, Edwin, M.D.Primary Care
Family Medicine
Munoz, Luz, P.A.Primary Care
Family Medicine
RECREDENTIALING PROVIDERS JUNE 2013
Name Specialty
Aldrich, Lisa, N.P.Mid-Level
Dermatology
Garcia, Isela, LCSW Mental Health Services
Ghizzoni, Maura, CNM Midwife
Kray, Margaret, N.P.Primary Care
Family Medicine
Lo, Eileen, O.D.Optometry
Matan, Joseph, M.D.Orthopaedic Surgery
Michael, James, P.A.Mid-Level
Orthopaedic Surgery Assistant
Moini, Marjaneh, M.D.Radiation Oncology
Valverde-Salas, Vicky, M.D.Primary Care
Family Medicine
CREDENTIALING ORGANIZATIONAL PROVIDERS
JUNE 2013
Provider Name Provide the Following
Services
Location
Professional Healthcare at Home,
LLC
dba: Professional Healthcare at
Home – Emeryville
Home Health Emeryville
Professional Healthcare at Home,
LLC
dba: Professional Healthcare at
Home Home Health Pleasant Hill
Home Health Pleasant Hill
Contra Costa Health Plan
Providers Approved by Medical Director
June 18, 2013
Page 2 of 2
CREDENTIALING ORGANIZATIONAL PROVIDERS
JUNE 2013
Provider Name Provide the Following
Services
Location
Professional Healthcare at Home,
LLC
dba: Professional Healthcare at
Home Hospice Pleasant Hill
Hospice Pleasant Hill
Professional Healthcare at Home,
LLC
dba: Professional Healthcare at
Home – Vacaville
Home Health Vacaville
RAI Care Centers of Northern
California I, LLC
dba: RAI Elk Grove Blvd, Elk
Grove
Dialysis Elk Grove
RAI Care Centers of Northern
California I, LLC
dba: RAI Harding Roseville
Dialysis Roseville
RAI Care Centers of Northern
California I, LLC
dba: RAI N. California Stockton
Dialysis Stockton
RAI Care Centers of Northern
California I, LLC
dba: RAI Secret Ravine Parkway
Roseville
Dialysis Roseville
bopl-June 18, 2013
Contra Costa Health Plan
Providers Approved by Peer Review and Credentialing Committee
July 9, 2013
CREDENTIALING PROVIDERS JULY 2013
Name Specialty
Fernandes, Deborah, M.D.Primary Care
Pediatrician
Mayor, Christine, N.P.Primary Care
Pediatrician
Murtha, Shaunna, LCSW Mental Health Services
Saunders, Mara, N.P.Primary Care
Geriatric Medicine
Shtivelman, Sarit, M.D.Primary Care
Pediatrician
RECREDENTIALING PROVIDERS JULY 2013
Name Specialty
Brown, Ryan, M.D.Cardiovascular Disease
Cheng, Eileen, O.D.Optometry
Dimidjian, Constance, N.P.Mid-Level
Family Planning
Gupta, Anurag, M.D.Cardiovascular Disease
Irwin, David, M.D.Hematology/Oncology
Liu, Michelle W., M.D.Ophthalmology
Ospina, Esperanza, P.A.Primary Care
Family Medicine
Ray, Sanjay, M.D.Internal Medicine/
Cardiovascular Disease
Sequeira, Juan, M.D.Primary Care
Internal Medicine
Tennant, Rebecca, M.D.Primary Care
Family Medicine
Wrone, Elizabeth, M.D.Nephrology
CREDENTIALING ORGANIZATIONAL PROVIDERS
JULY 2013
Provider Name Provide the Following
Services
Location
RAI Care Centers of Northern
California I, LLC
dba: RAI Ceres Ave Chico
Dialysis Chico
Contra Costa Health Plan
Providers Approved by Peer Review and Credentialing Committee
July 9, 2013
Page 2 of 2
RECREDENTIALING ORGANIZATIONAL PROVIDERS
JULY 2013
Provider Name Provide the Following
Services
Location
East Bay Integrated Care, Inc.
dba: Hospice of the East Bay
Hospice Pleasant Hill
bopl-July 9, 2013