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216.910 Powers and duties of network.
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Any licensed network shall be permitted to establish one (1) extension site per
full-time physician on the staff of the network. Extension sites shall not be
required to have a separate license but shall conform to administrative
regulations promulgated by the Cabinet for Health and Family Services and
shall be inspected on a regular basis.
Each network shall establish protocols for the treatment of the twenty (20) most
common patient problems. At a minimum, the protocols shall identify for each
problem a working definition, patient symptoms, diagnostic techniques,
acceptable values for laboratory findings, conditions under which a physician
shall be consulted, and treatment methods. These protocols shall be approved
by the board. The protocols shall be listed in a handbook provided to each
midlevel health-care practitioner and shall be available to patients upon
request.
Each network shall have a system of patient and family medical records which
employs the problem-oriented medical record format.
A network shall employ a primary-care physician who has admitting privileges
at a local hospital. The network shall hire ancillary personnel as necessary to
provide the basic services of the network. The network may hire midlevel
health-care practitioners to assist the physician but there shall be one (1)
physician on staff for each midlevel health-care practitioner.
A physician shall see each patient for whom services are provided by a
midlevel health-care practitioner not less than twice a year. A medical chart
auditor shall review the medical record entries for each patient encounter on
the day of the encounter and will refer to the physician immediately any
deviation from protocol.
Each network shall develop a quality assurance program which shall be
approved by the board. At a minimum, the quality assurance program shall
address:
(a) Program goals and objectives;
(b) Program organization, including identification of responsible parties, the
nature of their responsibilities, and the persons to whom they report; and
(c) Identification of the patient care process.
Each network shall establish a process by which it regularly evaluates the
health-care needs of its community and the services it provides in response to
those needs.
Each network shall provide the following educational opportunities:
(a) Ninety (90) minutes each week of continuing education to its health-care
providers on topics relating to patient care needs; and
(b) One and one-half (1.5) days leave and fifty percent (50%) of expenses up
to three hundred dollars ($300) per year to its midlevel health-care
practitioners for approved continuing education outside of the network.
Each network shall either provide directly for twenty-four (24) hour, seven (7)
day per week access to care for its patients or have formal written agreements
with local providers to insure twenty-four (24) hour, seven (7) day per week
access to care for its patients.
(10) No network may charge or collect more money for the services of any midlevel
health-care practitioner than is allowable under Medicaid for other
nonphysician practitioners.
Effective:June 20, 2005
History: Amended 2005 Ky. Acts ch. 99, sec. 497, effective June 20, 2005. -Amended 1998 Ky. Acts ch. 426, sec. 444, effective July 15, 1998. -- Created
1990 Ky. Acts ch. 482, sec. 3, effective July 13, 1990.
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