Tenn. Comp. R. & Regs. 1200-20-11-.06 - PROGRAM REQUIREMENTS

(1) The primary care physician or physician specialist seeking a J-1 visa waiver and the Chief Executive Officer of the sponsoring employer must each submit semi-annual reports to the Department which assure that the sponsoring employer and the physician are complying with the rules and regulations of the program. The first reports must be submitted within thirty (30) days after employment begins and every six (6) months thereafter, until the three-year commitment is complete. Reporting forms will be supplied to the physician and the sponsoring employer by the Department.

(2) All primary care physicians and physician specialists who have been granted a J-1 visa waiver are required to grant Department representatives, who shall maintain full confidentiality, reasonable access to all records maintained by the physician's practice which are pertinent to ascertaining compliance with these rules and regulations, including, but not limited to, patient files and payment records. From time to time, audits for compliance with these rules and regulations may be performed by staff of the Department.

(3) At all times, the primary care physician or physician specialist who has been granted a J-1 visa waiver must operate the practice consistent with established standards recognized or adopted by the appropriate medical specialty.

(4) A primary care physician and physician specialist who has been granted a J-1 visa waiver is not permitted to transfer from one site to another unless such physician receives prior written approval from the Department. An unapproved transfer may result in, among other things, cancellation of the visa waiver.

(5) All primary care physicians and physician specialists who have been granted a J-1 visa waiver must complete an exit interview within ninety (90) days of the completion of his/her three-year obligation, or at such point that the employment contract is terminated by the sponsoring site, the physician, or the Department. The Department will conduct the exit interview, which will concentrate on the physician's experiences in Tennessee and his/her future plans for practicing at the current location or another location.

(6) All primary care physicians and physician specialists who have been granted a J-1 visa waiver must agree to enroll with a sufficient number of MCOs which serve at least fifty-one percent (51%) of the TennCare enrolled population in the physician's primary county of practice. In the event that one (1) or more MCO's have closed enrollment to new providers which would not allow the physician to meet this criteria, the physician must demonstrate to the Department that a good faith effort was made and that the physician has enrolled in all other MCO's accepting new providers.

(7) All primary care physicians and physician specialists who have been granted a J-1 visa waiver must agree, without exception, to provide services to indigent patients as long as the provider's total number of indigent patient visits does not exceed fifteen percent (15%) of the provider's total practice visits.

(8) All primary care physicians and physician specialists who have been granted a J-1 visa waiver must accept assignment under Section 1842(b)(3)(ii) of the Social Security Act as full payment for all services for which payment may be made under Part B of Title XVIII of such Act (Medicare). All primary care physicians and physician specialists must also accept TennCare payment as payment in full for TennCare patients.

(9) The sponsoring employer must make known to the community that primary care physicians and physician specialists who have been granted a J-1 visa waiver will comply with the terms and conditions stated in these rules and regulations by posting a notice stating the terms and conditions in a conspicuous place in the public waiting area of the facility.

Notes

Tenn. Comp. R. & Regs. 1200-20-11-.06

Original rule filed May 30, 1997; effective September 28, 1997. Repeal and new rule filed April 28, 2000; effective July 12, 2000. Repeal and new rule filed December 12, 2003; effective February 25, 2004.

Authority: T.C.A. §§ 4-5-202, 4-5-204, 68-1-103, and Public Acts of 2003; Chapter 117.