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New Haven Community Medical Group

New Haven Community Medical Group (CMG) was created in January 2004 from its predecessor organization, Yale-New Haven Medical Staff IPA, to include community based members of Yale-New Haven Hospital (YNHH) Medical Staff. Approximately 585 members of the YNHH active Medical Staff are also members of CMG.

CMG Board of Directors and Administration

CMG is governed by an 11 member Board of Directors for the purpose of managed care contracting and clinical integration (CI). Board members are elected from the membership at large and are listed below. Board members serve a three-year term and are eligible to be re-elected for a maximum of three terms (9 years). Joseph Quaranta, MD, currently serves as president of CMG.


CMG Board of Directors

Paul Barcewicz, MD, Surgery
Agnes Czibulka, MD, Surgery
Phillip Dickey, MD, Neurosurgery
Sidney Bogardus, MD, Internal Medicine
Karen Brown, MD, Internal Medicine
Joseph Quaranta, MD, Internal Medicine
Alan Siegel, MD, Psychiatry
Craig Summers, MD, Pediatrics
Gregory Germain, MD, Pediatrics
Maria Asis MD, OBGYN
Thomas Thetford

Committees

CMG has a Credentials Committee that reviews applicants' and existing members compliance with CMG activity requirements (See CMG Requirements below); and a Technology Committee that focuses upon means by which CMG can assist its members in advancing technology in their practices. Additionally, several committees are involved in the development of clinical integration programs. A list and the respective chairs of the CMG committees are identified below:


Chair - Committee

Emily Nolfo, MD: Adult Medicine Clinical Integration
Kirsten Baker, MD:  Pediatric Asthma Clinical Integration
Ann Strong, M.D.:  Women’s Health
Steve Wolfson, MD:  Care Transition Clinical Integration
Agnes Czibulka, MD:  Surgery Clinical Integration
Alan Siegal, MD:  Behavioral Health Clinical Integration
Karen Brown, MD:  Clinical Integration Steering Committee

For more information about these committees, visit the http://www.nhcmg.org/.

CMG Credentials Committee

The CMG Credentials Committee is composed of CMG members in representative specialties. The committee meets monthly and is responsible for reviewing the applications of new and re-credentialed members of CMG. The committee delegates authority for verification of credentials to the Yale-New Haven Hospital Credentials Committee and focuses its work on reviewing CMG applicants and re-applicant's compliance with the CMG-specific requirements described below.


CMG Membership

The CMG credentials physicians, podiatrists, dentists and allied health providers for membership. Complete requirements and process for new and re-credentialing of CMG prospective and existing members are fully described in the New Member Credentialing Policy and Procedure and the Re-Credentialing Policy and Procedure.

Existing CMG members must fulfill CMG requirements on an ongoing basis. Compliance is reviewed every two years concurrent and with the same application process used in re-appointment to the YNHH Medical Staff.

CMG contracted health plans

CMG contracts with the health plans listed below:

Aetna*
Connecticare
Coventry/First Health*
MultiPlan*
United Healthcare*

*indicates plans for which the YNHH Department of Physician Services has delegated credentialing.

CMG requirements

CMG requires that its members fulfill criteria in the areas of clinical activity, teaching or administrative activity, clinical integration and network connectivity. Activities must be at or related to Yale-New Haven Hospital.

Members are required to provide documentation of having fulfilled these criteria every three years, in accordance with NCQA regulations.

For full description of the requirements, please refer to the New Member Credentialing Policy and Procedure and the Re-Credentialing Policy and Procedure.

Medical Staff Category

Members of CMG must maintain membership on the YNHH Medical Staff as an "attending", "associate", or "courtesy" staff member in order to be, and remain, eligible for CMG Membership.


Clinical Criteria

Clinical criteria for each specialty area are indicated in the documents below. The clinical criteria mirror the requirements for a member of the YNHH Medical Staff to remain on the hospital's staff and consist of a specific number of admissions/discharges/cases, consultations or inpatient visits depending upon the area of practice.


Teaching/administrative criteria

CMG members must also participate in some teaching and/or administrative activity relative to YNHH. The list below indicates some examples of activities that would fulfill this requirement:


Teaching activities

  • Precepting Yale University medical students, physician assistant students, nursing students, or YNHH house staff and clinical fellows in the private office setting.
  • Attending in resident or fellow clinics or other YNHH network facilities or clinics at YNHH or the West Haven VA Medical Center.
  • Inpatient attending at YNHH or WHVAMC.
  • Giving lectures to Yale medical students or YNHH resident physicians.
  • Conducting Grand Rounds or other teaching conferences.
  • Attending morning report for YNHH inpatient services.
  • Other sectional, departmental, or YNHH teaching activities as approved by the Credentials Committee.
  • Attending in Yale-New Haven Medical Staff CMG floating clinic.
  • Other clinical quality programs approved by the CMG Credentials Committee.

Administrative activities

  • YNHH Medical Board or committees of the Medical Board (i.e. Tissue, Infection Control, Credentials, Ethics, Operating Room, etc.).
  • Departmental committees, i.e. medical board, infection control.
  • Quality assurance activities of the member's respective department or CMG Clinical Integration Committees.
  • Board or committees of the YNHH Medical Staff or CMG.
  • Other sectional, departmental or YNHH or CMG administrative activities as approved by the Credentials Committee.

Network connectivity

Members of CMG are also required to demonstrate network connectivity through one of the means listed below:

  • Participation in MDlink or related system
  • Fax of summary reports to and from related system or Yale-New Haven Hospitalist Team
  • Electronic medical record in use in private practice
  • Other CI communication systems as applicable to capture quality and control costs as approved by the Credentials Committee
Members will be asked to report on their network connectivity at the time of re-credentialing and to provide evidentiary documentation.


CMG credentialing and application process

CMG is contracted with the YNHH Department of Physician Services for the provision of credentialing services for CMG. The Department of Physician Services has obtained delegated credentialing from the CMG-contracted health plans as indicated with an asterisk (*) under "CMG Contracted Health Plans."

For those plans with delegated credentialing, the credentialing application materials you complete for the YNHH Medical Staff may be able to be utilized for CMG credentialing (see A and B below).

Recredentialing application materials that you complete for YNHH Medical Staff are always utilized for CMG and those health plans with which you participate through CMG.


Application Submission

At this time, electronic submission is not available. You must, therefore, print out all forms and submit them in hard copy. All materials should be submitted to the following address:

New Haven Community Medical Group

Yale-New Haven Hospital, Dept. of Physician Services
20 York Street, Hunter 4
New Haven, CT 06510

Materials may be submitted via U.S. Postal Service, Federal Express or in person. The Department of Physician Services is located on the fourth floor of the Hunter Building. For specific directions, please call 203.688.2615.

New Applicants

Important notes


  • Opt-in forms and their attached contract appendices reference the Yale-New Haven Medical Staff IPA, this organization was re-named as New Haven Community Medical Group in August 2012.
  • Once your application is received, you will be contacted in regard to any additional information to supplement your YNHH Medical Staff application that may be required for CMG membership.


Approval process

Following receipt of your application materials and approval of your membership on the Yale-New Haven Hospital Medical Staff, your application will be forwarded to the CMG Credentialing Committee, and then to the CMG Board of Directors, for consideration. Once complete, applications for individuals who are already members of the YNHH Medical Staff will be forwarded directly to the CMG Credentials Committee. Please note that only complete applications will presented for membership determination. Be sure to provide all materials that have been requested.

Applicants are entitled to request the status of their credentialing applications, as described in the Applicant/Members Access to Files and Correction of Information Policy.

The process utilized by the CMG ensures that credentialing is conducted in a manner that is non-discriminatory. Membership determinations are not based upon the applicant's age, race, gender, ethnicity, sexual orientation, types of patients served or types of procedures performed. YNHH Department of Physician Services staff and members of the New Haven Community Medical Group Credentials Committee and Board of Directors sign nondiscriminatory agreements to acknowledge their understanding of and compliance with this policy.

For more information, visit the New Haven Community Medical Group Web site at

http://www.nhcmg.org/

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