(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 physicians 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.
