Provider is a person with an unrestricted license or other authorization to practice in the state of location. A copy of providers current valid license shall be provided with Providers application to MHC.
Provider, where applicable, has not and shall not have any hospital appointment or privileges reduced, limited, suspended or terminated or been placed on probation by any hospital at which Provider has had a medical or professional staff appointment or privileges; been restricted from receiving payments from Medicare, Medicaid or any other third party reimbursement programs; been subject to disciplinary action by any state or local medical society, specialty society, state board of medical examiners or the Drug Enforcement Agency; or been subject to sanctions of any kind whatsoever by any person or entity for improper prescribing procedures or actions; provided however, that in the discretion of MHC the foregoing shall not apply to suspensions related to a reasonable delay in completing medical records. Any such actions shall be reported on the application.
Provider shall, if permitted under Providers license, have and maintain unrestricted prescribing privileges. A copy of providers current DEA certification shall be provided with the application.
Provider has not and shall not have been disciplined, suspended or terminated from a PPO, HMO or other managed care organization.
Provider has not been convicted of a felony.
Provider is in good general health. Provider shall report on the application any physical or mental problem that may affect Providers ability to practice Providers profession. If provider has such disabilities the provider shall provide, with the application, a statement from Providers personal physician stating that the disabilities shall not interfere with the providers ability to provide high quality medical care. Provider shall certify on the application that the Provider does not have a history of and is not presently abusing drugs or alcohol. A Provider with a history of drug or alcohol abuse may be considered for membership in MHC, within the sole discretion of MHC, if assured of proper rehabilitation. Provider shall certify on the application that Provider does not have any communicable and/or chronic infectious disease that may be a potential danger to patients. MHC shall have sole discretion in the determination of the impact of the health status of Provider for purposes of credentialing.
Provider shall purchase and maintain policies of liability insurance in the amounts required by MHC. At present time, such insurance shall be $1,000,000.00 for each claim, $3,000,000.00 aggregate.