HomeMy WebLinkAboutMINUTES - 10072014 - C.103RECOMMENDATION(S):
Approve the list of providers recommended by the Contra Costa Health Plan's Medical Director on August 27, 2014
and September 9, 2014, 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: 10/07/2014 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: October 7, 2014
David Twa, County Administrator and Clerk of the Board of Supervisors
By: Chris Heck, Deputy
cc: T Scott, C Rucker, L Maria Pereez
C.103
To:Board of Supervisors
From:William Walker, M.D., Health Services Director
Date:October 7, 2014
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
August List
September List
Contra Costa Health Plan
Providers Approved by Medical Director
August 27, 2014
CREDENTIALING PROVIDERS AUGUST 2014
Name Specialty
Britten, Michelle, BCBA Mental Health Services - Behavior
Analysis
Brown, Holly J., MFT Mental Health Services
Gomez, Michele A., M.D. Family Planning
Kiff, Natalie M., LCSW Mental Health Services
Long, Molly M., LCSW Mental Health Services
Thomas, Glenn, LCSW Mental Health Services
Wozmak, Nicolas A., M.D. Anesthesiology
RECREDENTIALING PROVIDERS AUGUST 2014
Name Specialty
Adey, Geoffrey R., M.D. Surgery – Neurological
Amin, Farzana, M.D. Psychiatry
Blumenstock, Edward M., M.D. Family Planning
Burack, Jeffrey H., M.D. HIV/Aids
Dixon, Patrick W., MFT Mental Health Services
Gendo, Karna, M.D. Allergy & Immunology
Hall, Christopher S., M.D. HIV/Aids
Herlihy, Nelson W., P.A. Mid-Level
Orthopaedic Surgery Assistant
Jacobs, Joshua S., M.D. Allergy & Immunology
Johnson, Robert N., M.D. Ophthalmology
Kumelachew, Hiruth, P.A. Mid-Level
Family Planning
Nelson, Ingrid, N.P. Primary Care
Internal Medicine
HIV/Aids
O’Brien, Stephen, M.D. HIV/Aids
Risgalla, H. Edward, M.D. Primary Care
Pediatrician
Samuels, Kimally L., MFT Mental Health Services
Su, Fannie W., M.D. Allergy & Immunology
Superfin, Diana, M.D. Medical Oncology
Tevrizian, Allyson T., M.D. Allergy & Immunology
Contra Costa Health Plan
Providers Approved by Medical Director
August 27, 2014
Page 2 of 2
CREDENTIALING ORGANIZATIONAL PROVIDERS
AUGUST 2014
Provider Name
Provide the Following
Services
Location
Alere Inc.
dba: Alere Women’s and Children’s
Health, LLC
Home Health Clovis
Canyon Pinole Surgery Center, LP
dba: Canyon Pinole Surgery Center
Outpatient Surgery Pinole
Crescent Healthcare, Inc.
dba: Crescent Healthcare
Infusion Therapy Hayward
RECREDENTIALING ORGANIZATIONAL PROVIDERS
AUGUST 2014
Provider Name
Provide the Following
Services
Location
Aspen Surgery Center, LLC
dba: Aspen Surgery Center
Outpatient Surgery Walnut Creek
Brentwood Surgery Center, LLC
dba: Brentwood Surgery Center
Outpatient Surgery Brentwood
Vintage Estates, III, Inc.
dba: Vintage Estates of Richmond
Skilled Nursing Facility Richmond
bopl-August 27, 2014
Contra Costa Health Plan
Providers Approved by Peer Review and Credentialing Committee
September 9, 2014
CREDENTIALING PROVIDERS SEPTEMBER 2014
Name Specialty
Aceves, Angela A., O.D. Optometry
Goodwin, Karen M., D.O. Surgery – General
Lease, Lawrence M., MFT Mental Health Services
Littlefield, Matthew T., M.D. Psychiatry
Lo, Stephen H., M.D. Anesthesiology
Shell, Amy M., N.P. Mid-Level
Allergy & Immunology
Tong, Wilson P., M.D. Oncology
RECREDENTIALING PROVIDERS SEPTEMBER 2014
Name Specialty
Armstrong, Ingrid M., Au.D. Audiology
Barcenas, Olivia S., MFT Mental Health Services
Brinton, Daniel A., M.D. Ophthalmology
Brophy, Donald R., D.C. Chiropractic Medicine
Chen, Terence L., M.D. Surgery – Neurological
Chiu, Noel T.D., M.D. Dermatology
Cutler, Corey, N.P. Primary Care
Family Medicine
D’Arata, Michael, N.P. Mid-Level
HIV/Aids
Kuhfal, Bonny J., HAD Hearing Aid Dispensing
Leon, Ronald L., M.D. Psychiatry
Lit, Eugene S., M.D. Ophthalmology
Lobao, Jeannette D., Psy.D. Bariatric Evaluations
Makooi, Mahmood M., D.C. Chiropractic Medicine
Pao, Elsa T., O.D. Optometry
Ribble, Lyssa N., N.P. Mid-Level
Family Planning
Royal, Deborah H., N.P.
Mid-Level
HIV/Aids
Shey, Jason J., M.D. Nephrology
Sundar, Sam, M.D. Primary Care
Internal Medicine
White, Charles F., M.D. Primary Care
General Practice
Wolfe, Michelle G., M.D. Family Planning
bopl-September 9, 2014