Current through all regulations passed and filed through September 16, 2024
(A)
As used in this
rule:
(1)
"Full-time practice" means working a minimum of forty hours
per week for a minimum of forty-five weeks each service year. Practice related
administrative duties may not exceed eight hours per week.
(2)
"Part-time
practice" means working a minimum of twenty hours and a maximum of thirty-nine
hours per week for a minimum of forty-five weeks each service year. Practice
related administrative activities may not exceed four hours per
week.
(3)
"Teaching activities" means providing clinical
education to health professions students and residents regarding the normal
course of practice and expertise at the practice site(s) specified in the
contract. Full-time practitioners may spend up to eight hours per week
conducting both practice related administrative activities and teaching in the
clinical setting at the approved practice site(s). Part-time practitioners may
spend up to four hours per week conducting both practice related administrative
duties and teaching in the clinical setting at the approved practice
site(s).
In order to qualify as teaching, the
physician must be providing clinical education and supervision of students or
clinicians in the approved practice site(s) as part of an accredited clinical
training program.
All teaching must be conducted at the
practice site(s) specified in the physician's contract. If the supervising
physician provides primary care services while the student or clinician
observes, the activity should be treated as direct patient care rather than
teaching.
(4)
"Telemedicine activities" means providing primary care
services using an interactive telecommunications system, defined as multimedia
communication equipment that includes, at a minimum, audio and video equipment
permitting two-way real time interactive communication between the patient at
the originating site(s) and the physician at the practice site(s) approved by
the department and agreed upon by the physician and the director. Full-time
practitioners may count up to eight hours per week in telemedicine activities
as patient care at the approved practice site(s). Part-time practitioners may
count up to four hours per week in telemedicine activities as patient care at
the approved practice site(s).
In order to qualify as telemedicine
activities, both the originating site(s) (location of the patient) and the
approved practice site(s) must be located in health resource shortage
areas.
All telemedicine activities must be
conducted at the practice site(s) specified in the physician's
contract.
(B)
A primary care
physician who has signed a letter of intent under paragraph (E) of rule
3701-6-02 of the Administrative
Code and the director may enter into a contract providing for the physician's
participation in the physician loan repayment program. The physician's employer
or another funder may also be a party to the contract.
(C)
The contract
shall include all of the following obligations:
(1)
Agreement by the
primary care physician to provide primary care services in the health resource
shortage area(s) and practice site(s) approved by the department and agreed
upon by the physician and director for the duration specified in the
contract.
(2)
Agreement by the primary care physician that, in
providing primary care services in the health resource shortage area(s), he or
she will do all of the following:
(a)
Provide primary care services in full-time practice or
part-time practice as specified in the contract;
(b)
Provide primary
care services without regard to a patient's ability to pay;
(c)
Meet the
conditions prescribed by the "Social Security Act," 49 Stat. 620 (1935),
42 U.S.C.
301 as amended (1981), and the Ohio
department of medicaid for participation in the medicaid program established
under Chapter 5160. of the Revised Code and enter into a contract with the Ohio
department of medicaid and its contracting managed care plans to provide
primary care services to recipients of the medicaid program.
(d)
Accept into his
or her practice a percentage of individuals determined eligible for the
medicaid program described in paragraph (C)(2)(c) of this rule at least equal
to the percentage of the general population in that health resource shortage
area(s) which has been determined eligible for the medicaid
program.
(3)
Agreement by the department, as provided in section
3702.75 of the Revised Code, to
repay, so long as the primary care physician performs the service obligation to
which he or she has agreed under paragraph (C)(1) of this rule, all or part of
the primary care physician's educational expenses, as defined in paragraph (C)
of rule 3701-6-01 of the Administrative
Code.
(4)
Agreement by the primary care physician to pay the
department the following as damages if he or she fails to complete the service
obligation to which he or she has agreed under paragraph (C)(1) of this
rule:
(a)
Three
times the amount the department has agreed to repay under paragraph (C)(3) of
this rule; or
(b)
If funds from another source are used to repay a
portion of the physician's loan, damages owed if the physician fails to
complete the obligation will be the damages specified by the other source of
the funds, or as outlined in paragraph (C)(4)(a) of this rule, whichever is
greater.
(5)
If the department assumes the physician's duty to pay a
portion of the loan, the contract shall set forth the amount of each
payment.
(D)
The contract shall include the following terms as
agreed upon by the parties:
(1)
The physician's required length of service in the
health resource shortage area(s) which must be at least two years for an
initial contract. Contracts may be renewed for no more than two additional one
year periods;
(2)
The physicians commitment to full-time practice or
part-time practice;
(3)
The maximum amount that the department will repay on
behalf of the physician;
(4)
The extent to which the physician's teaching activities
as defined under paragraph (A)(3) of this rule will be counted toward the
physician's full-time or part-time practice hours under the contract;
and
(5)
The extent to which the physician's telemedicine
activities as defined under paragraph (A)(4) of this rule will be counted
toward the physician's full-time or part-time practice hours under the
contract.
(E)
In addition to the terms required under paragraph (C)
of this rule, the contract may contain other terms agreed upon by the
parties.
Replaces: 3701-6-03