HomeMy WebLinkAboutMINUTES - 09152015 - C.89RECOMMENDATION(S):
Approve the list of providers recommended by the Contra Costa Health Plan's (CCHP) Peer Review and
Credentialing Committee on August 11, 2015, 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:
Not applicable.
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: 09/15/2015 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
ABSENT:Mary N. Piepho, District III
Supervisor
Federal D. Glover, District V
Supervisor
Contact: Patricia Tanquary, (925)
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: September 15, 2015
David Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc: T Scott, Natalie Rios, Heather Wong
C. 89
To:Board of Supervisors
From:William Walker, M.D., Health Services Director
Date:September 15, 2015
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
Attachment
Contra Costa Health Plan
Providers Approved by Peer Review and Credentialing Committee
August 11, 2015
CREDENTIALING PROVIDERS AUGUST 2015
Name Specialty
Angle, Niren, MD Surgery - Vascular
Bellini, Lisa, RD Dietitian
Bernstein, Carolyn, NP Mid-Level
Surgery - General
Choun, Haerim, BCBA Behavior Analysis
Do, Nguyen, D.O. Surgery - Neurological
Fowler, Morgan, BCBA Behavior Analysis
Gaitan, Patricia, M.D Primary Care Pediatrician
Gavini, Aruna, M.D. Hematology/Oncology
Haake, Curtis, DC Chiropractic Medicine
Hounshell, Lynda, BCBA Behavior Analysis
Lo, Irene, M.D. Surgery - General
Marroquin, Edmund, M.D. Anesthesiology
Michaelis, Linda, RD Dietitian
Murphy, Aileen, D.O. Surgery - General
Phillips, Lauren, PhD Mental Health Services
Pillai, Prasad, M.D. Hematology/Oncology
Ramirez, Ashley, BCBA Behavior Analysis
Thompson, Melissa, LCSW Mental Health Services
Vonderheide, Blake, M.D. Anesthesiology
Wilson, Teshina, D.O. Primary Care
Family Medicine
Young, Janet, M.D. Nephrology
CREDENTIALING ORGANIZATIONAL PROVIDERS
AUGUST 2015
Provider Name
Provide the Following
Services
Location
Coram Healthcare Corporation of
Northern California
dba: Coram CVS/Specialty Infusion
Services
Home Health Hayward
Holistic Care at Home, Inc
dba: Holistic Care at Home, Inc.
Home Health Oakland
Laser Surgery Center, LTD
dba: Laser Surgery Center, LTD
Surgery Center Walnut Creek
Contra Costa Health Plan
Providers Approved by Peer Review and Credentialing Committee
August 11, 2015
Page 2 of 3
Marie Star Home Health Services,
LLC
dba: Marie Star Home Health
Services, LLC
Home Health Concord
RECREDENTIALING PROVIDERS AUGUST 2015
Name Specialty
Banks, Norman, M.D. Primary Care
Family Medicine
Beyzer, Lyudmila, M.D. Primary Care
Internal Medicine
Borgman, Giana, NP Mid-Level Family Planning
Chiu, May, M.D. Nephrology
Gupta, Ravinder, M.D. Primary Care
Internal Medicine
Gutierrez, Susan, M.D. Pain Management
Klein, Louis, M.D. OB/GYN
LeNoir, Michael, M.D. Primary Care
Pediatrician/
Pediatric Allergy & Immunology
Pojman, Andrew, Ed.D. Mental Health Services
Rose, Joseph, M.D. OB/GYN
Scales, M. Donovan, MFT Mental Health Services
Severin, Sanford, M.D. Ophthalmology
Simms, Elizabeth, NP Mid-Level Perinatology
Skipper, Beverly, RDO Dispensing Optician
Sun, Jason, M.D. Hematology/Oncology
Trifiletti, Christina, O.D. Optometry
Vu, Cuong, M.D. Primary Care
Family Medicine
Williams, Cynthia, CNM Mid-Level Family Planning
RECREDENTIALING ORGANIZATIONAL PROVIDERS
AUGUST 2015
Provider Name
Provide the Following
Services
Location
DaVita – DVA Healthcare Renal
Care, Inc.
dba: Oakland Dialysis
Dialysis Oakland
Contra Costa Health Plan
Providers Approved by Peer Review and Credentialing Committee
August 11, 2015
Page 3 of 3
bopl August 11, 2015
DaVita –DVA Healthcare Renal
Care, Inc.
dba: Berkeley Dialysis
Dialysis Berkeley
DaVita – DVA Renal Healthcare,
Inc.
dba: Benicia Dialysis
Dialysis Benicia
DaVita – Llano Dialysis, LLC
dba: San Pablo Dialysis
Dialysis San Pablo
DaVita – Total Renal Care, Inc.
dba: TRC Antioch Dialysis Center
Dialysis Antioch
DaVita – Walker Dialysis, LLC
dba: Fremont at Home
Dialysis Fremont