SB1617 EnrolledLRB103 25020 CPF 52743 b

1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Health Care Professional Credentials Data
5Collection Act is amended by changing Section 5 as follows:
 
6    (410 ILCS 517/5)
7    Sec. 5. Definitions. As used in this Act:
8    "Council" means the Health Care Credentials Council.
9    "Credentials data" means those data, information, or
10answers to questions required by a health care entity, health
11care plan, or hospital to complete the credentialing or
12recredentialing of a health care professional.
13    "Credentialing" means the process of assessing and
14validating the qualifications of a health care professional.
15    "Department" means the Department of Public Health.
16    "Director" means the Director of the Department of Public
17Health.
18    "Health care entity" means any of the following which
19require the submission of credentials data: (i) a health care
20facility or other health care organization licensed or
21certified to provide medical or health services in Illinois,
22other than a hospital; (ii) a health care professional
23partnership, corporation, limited liability company,

 

 

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1professional services corporation or group practice; or (iii)
2an independent practice association or physician hospital
3organization. Nothing in this definition shall be construed to
4mean that a hospital is a health care entity.
5    "Health care plan" means any entity licensed by the
6Department of Insurance as a prepaid health care plan or
7health maintenance organization or as an insurer which
8requires the submission of credentials data.
9    "Health care professional" means any person licensed under
10the Medical Practice Act of 1987 or any person licensed under
11any other Act subsequently made subject to this Act by the
12Department.
13    "Hospital" means a hospital licensed under the Hospital
14Licensing Act or any hospital organized under the University
15of Illinois Hospital Act.
16    "Recredentialing" means a the process undertaken for a
17period not to exceed 3 years by which a health care entity,
18health care plan or hospital ensures that a health care
19professional who is currently credentialed by the health care
20entity, health care plan or hospital continues to meet the
21credentialing criteria used by the health care entity, health
22care plan, or hospital no more than once every 2 years.
23    "Single credentialing cycle" means a process undertaken
24for a period not to exceed 3 years whereby for purposes of
25recredentialing each health care professional's credentials
26data are collected by all health care entities and health care

 

 

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1plans that credential the health care professional during the
2same time period and only once every 2 years.
3    "Site survey" means a process by which a health care
4entity or health care plan assesses the office locations and
5medical record keeping practices of a health care
6professional.
7    "Single site survey" means a process by which, for
8purposes of recredentialing, each health care professional
9receives a site visit only once every two years.
10    "Uniform health care credentials form" means the form
11developed by the Department under Section 15 to collect the
12credentials data commonly requested by health care entities
13and health care plans for purposes of credentialing.
14    "Uniform health care recredentials form" means the form
15developed by the Department under Section 15 to collect the
16credentials data commonly requested by health care entities
17and health care plans for purposes of recredentialing.
18    "Uniform hospital credentials form" means the form
19developed by the Department under Section 15 to collect the
20credentials data commonly requested by hospitals for purposes
21of credentialing.
22    "Uniform hospital recredentials form" means the form
23developed by the Department under Section 15 to collect the
24credentials data commonly requested by hospitals for purposes
25of recredentialing.
26    "Uniform site survey instrument" means the instrument

 

 

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1developed by the Department under Section 25 to complete a
2single site survey as part of a credentialing or
3recredentialing process.
4    "Uniform updating form" means a standardized form for
5reporting of corrections, updates, and modifications to
6credentials data to health care entities, health care plans,
7and hospitals when those data change following credentialing
8or recredentialing of a health care professional.
9(Source: P.A. 91-602, eff. 8-16-99.)