SCS/HB 32 - This act would allow individual physicians to be designated as "Essential Community Providers" to serve medically underserved areas or in health professional shortage areas as designated by the Secretary of the Department of Health and Human Services.

Any physician seeking a designation of "essential community provider" must apply to the Director of the Department of Health and document that at least 40% of their practice is comprised of: (a) Medicaid or uninsured patients, or both; (b) or a combination of Medicaid and uninsured patients and Medicare or underinsured patients. The physician must serve a medically underserved area or a health professional shortage are and spend a minimum of 20 hours per week in such area. The physician must also be available to patients evenings and weekends. The physicians must also have hospital staff privileges with a participating network hospital of the health care insurer. An "essential community provider" cannot be a direct employee of a health care insurer.

The Department of Health shall issue a letter of designation as an essential community provider to any physician who makes a written request and application to the Department, if the physician meets the qualification of an essential community provider. The Department shall keep the names and addresses of all essential community providers on record and shall release this information upon request.

Any health care insurer offering or marketing group policies or contracts for health care coverage shall allow each essential community provider to submit an application to such health care insurer for inclusion in the health care network. Names of each "essential community provider" acting as a primary care physician shall appear in publications distributed to consumers or enrollees of the health care plan. This requirement shall not apply to medical group/staff model health maintenance organizations.

The title "essential community provider" can't be transferred to another physician, health care provider or site. The essential community provider shall submit an annual affidavit stating that such provider continues to meet the qualifications of an essential community provider and shall notify the Department of Health within thirty days of any changes that affect the certification requirements.

The limits provided in Section 191.227 shall be increased or decreased on an annual basis effective January 1 of each year in accordance with the Health Care Financing Administration Market Basket Survey.

CHERYL GRAZIER