NYS Licensure / Insurance Enrollments Making Sense of the Process

1. This presentation will probably involve audience discussion, which will create action items. Use PowerPoint to keep track of these action items during your presentation • In Slide Show, click on the right mouse button • Select “Meeting Minder” • Select the “Action Items” tab • Type in action items as they come up • Click OK to dismiss this box • This will automatically create an Action Item slide at the end of your presentation with your points entered. NYS Licensure /Insurance Enrollments Making Sense of the Process

2. New York State Medical License • Licensure process • NYS Application • FCVS (if applicable) • A physician must have a New York State Medical License in order to apply for and obtain: • Malpractice Coverage • DEA Certificate

3. Web Sites • NYS Education Department www.op.nysed.gov (Licensure requirements, applications) • Federation Credentials Verification Services: www.fsmb.org - click on FCVS / FSMB Credentials Verification Service Home Page / Physicians. Information and applications available. • Health Professional Shortage Areas http://hpsafind.hrsa.gov • NYS Department of Health www.highered.nysed.gov/kiap/scholarships/precoll/ Loan forgiveness applications and sites provided that meet the requirements. • DEA Diversion Control Program (on-line application) http://www.deadiversion.usdoj.gov/

4. NYS Medical Licensure U.S. Medical Graduates • M.D./D.O./D.P.M. Degree from an accredited program by the Liaison Committee on Medical Education (LCME) • M.D. and D.O.’s: Application accepted after completion of one year of an Accredited Graduate Medical Education program (Internship / Residency) • USMLE Steps 1, 2, & 3 (www.fsmb.org – Examination Services) OR • NBOME Parts I, II, & III (www.nbome.org)

5. NYS Medical Licensure International Medical Graduates • Completion of an acceptable educational program for physicians by the appropriate civil authorities of the country in which the school is located and receipt of the degree of Doctor of Medicine, or the equivalent as determined by the NYS Department of Education. • Educational Commission for Foreign Medical Graduates (ECFMG) certification. • The FCVS application process should be started at the beginning of your residency. A copy of the completed FCVS packet needs to be sent to the Medical Board of the State you will be seeking employment in.

6. NYS Medical Licensure International Medical Graduates • Completion of three (3) years Residency in an Accredited Graduate Medical Education program. NYS license application may be submitted any time in last year of training. • Verification of residency accepted by NYS 30 days prior to completion of training.

7. FCVS • FCVS packet now accepted in 48 out of 50 states • Not accepted in Nebraska and Arkansas • Mandatory* in 13 states: • Kentucky; Louisiana; New Hampshire; Ohio; Maine; Nevada (Osteopath only); New York; North Carolina; Rhode Island; South Carolina; Wyoming; Utah; Virgin Islands * FCVS profile required from applicants who completed their Medical Education at a non-LCME or AOA accredited or board approved facility.

8. Physician Applications • Hospital Medical Staff application(s) • Malpractice and Personnel Packets • Third Party Payors: Any insurance company that the employer participates with, i.e., Excellus, MVP, etc.

9. Enrollments • Begins upon receipt of signed Physician contract. • Applications are filled out and sent to physician/provider for completion of confidential/personal information, signature and date. • Request made for all mandatory documents to be returned with applications. • Return envelopes provided.

10. Mandatory Documents • The following documents must be obtained and submitted with third party payor applications: • NYS Medical License • DEA Certificate • Curriculum Vitae (month / year format) • Malpractice Certificate • Medical School / Graduate Education Diploma

11. Completion of Residency Certificate(s) • Completion of Fellowship Certificate(s) • Board Certificate(s) - if applicable • Proof of past malpractice coverage (if applicable) • ECFMG (if an International Medical Graduate) • Social Security Card • NPI notification letter (if available, user ID & password) • CAQH ID number (if available, user ID & password)

12. Malpractice Insurance • Claims Made • Coverage for any incident is provided only while you are insured under this policy. Once this policy is no longer in force, “tail coverage” should be purchased by either you or your employer to protect you for claims that may come about during the policy period. • Occurrence • This policy protects you no matter when a claim is brought against you.

13. Application Enrollment • Applications returned from the physician/provider are copied for our files. • Only when a complete packet of Mandatory documents are obtained, can the applications be submitted. • Third party payors can take up to three months to process once all documentation has been received in the insurance credentialing office.

14. Potential “Road Blocks” • NYS License • Residency Certificate • Malpractice Certificate • Professional References • MCO’s Committee Meetings

15. Moonlighting Residents • Malpractice and Personnel Packets • Third Party Payors Minimal participation for residents (i.e., Medicare, Medicaid, PA Medicaid)