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92_HB1954ham001
LRB9200934LBgcam01
1 AMENDMENT TO HOUSE BILL 1954
2 AMENDMENT NO. . Amend House Bill 1954 by replacing
3 everything after the enacting clause with the following:
4 "Section 5. The Health Care Professional Credentials
5 Data Collection Act is amended by changing Sections 15, 20,
6 and 25 as follows:
7 (410 ILCS 517/15)
8 Sec. 15. Development and use of uniform health care and
9 hospital credentials forms.
10 (a) The Department, in consultation with the council,
11 shall by rule establish:
12 (1) a uniform health care credentials form that
13 shall include the credentials data commonly requested by
14 health care entities and health care plans for purposes
15 of credentialing and shall minimize the need for the
16 collection of additional credentials data;
17 (2) a uniform health care recredentials form that
18 shall include the credentials data commonly requested by
19 health care entities and health care plans for purposes
20 of recredentialing and shall minimize the need for the
21 collection of additional credentials data;
22 (3) a uniform hospital credentials form that shall
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1 include the credentials data commonly requested by
2 hospitals for purposes of credentialing and shall
3 minimize the need for the collection of additional
4 credentials data;
5 (4) a uniform hospital recredentials form that
6 shall include the credentials data commonly requested by
7 hospitals for purposes of recredentialing and shall
8 minimize the need for collection of additional
9 credentials data; and
10 (5) uniform updating forms.
11 (b) The uniform forms established in subsection (a)
12 shall be coordinated to reduce the need to provide redundant
13 information. Further, the forms shall be made available in
14 both paper and electronic formats.
15 (c) The Department, in consultation with the council,
16 shall establish by rule a date after which an electronic
17 format may be required by a health care entity, a health care
18 plan, or a hospital, and a health care professional may
19 require acceptance of an electronic format by a health care
20 entity, a health care plan, or a hospital.
21 (d) Beginning January July 1, 2002 2000, each health
22 care entity or health care plan that employs, contracts with,
23 or allows health care professionals to provide medical or
24 health care services and requires health care professionals
25 to be credentialed or recredentialed shall for purposes of
26 collecting credentials data only require:
27 (1) the uniform health care credentials form;
28 (2) the uniform health care recredentials form;
29 (3) the uniform updating forms; and
30 (4) any additional credentials data requested.
31 (e) Beginning January July 1, 2002 2000, each hospital
32 that employs, contracts with, or allows health care
33 professionals to provide medical or health care services and
34 requires health care professionals to be credentialed or
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1 recredentialed shall for purposes of collecting credentials
2 data only require:
3 (1) the uniform hospital credentials form;
4 (2) the uniform hospital recredentials form;
5 (3) the uniform updating forms; and
6 (4) any additional credentials data requested.
7 (f) Each health care entity and health care plan shall
8 complete the process of verifying a health care
9 professional's credentials data in a timely fashion and shall
10 complete the process of credentialing or recredentialing of
11 the health care professional within 60 days after submission
12 of all credentials data and completion of verification of the
13 credentials data.
14 (g) Each health care professional shall provide any
15 corrections, updates, and modifications to his or her
16 credentials data to ensure that all credentials data on the
17 health care professional remains current. Such corrections,
18 updates, and modifications shall be provided within 5
19 business days for State health care professional license
20 revocation, federal Drug Enforcement Agency license
21 revocation, Medicare or Medicaid sanctions, revocation of
22 hospital privileges, any lapse in professional liability
23 coverage required by a health care entity, health care plan,
24 or hospital, or conviction of a felony, and within 45 days
25 for any other change in the information from the date the
26 health care professional knew of the change. All updates
27 shall be made on the uniform updating forms developed by the
28 Department.
29 (h) Any credentials data collected or obtained by the
30 health care entity, health care plan, or hospital shall be
31 confidential, as provided by law, and otherwise may not be
32 redisclosed without written consent of the health care
33 professional, except that in any proceeding to challenge
34 credentialing or recredentialing, or in any judicial review,
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1 the claim of confidentiality shall not be invoked to deny a
2 health care professional, health care entity, health care
3 plan, or hospital access to or use of credentials data.
4 Nothing in this Section prevents a health care entity, health
5 care plan, or hospital from disclosing any credentials data
6 to its officers, directors, employees, agents,
7 subcontractors, medical staff members, any committee of the
8 health care entity, health care plan, or hospital involved in
9 the credentialing process, or accreditation bodies or
10 licensing agencies. However, any redisclosure of credentials
11 data contrary to this Section is prohibited.
12 (i) Nothing in this Act shall be construed to restrict
13 the right of any health care entity, health care plan or
14 hospital to request additional information necessary for
15 credentialing or recredentialing.
16 (j) Nothing in this Act shall be construed to restrict
17 in any way the authority of any health care entity, health
18 care plan or hospital to approve, suspend or deny an
19 application for hospital staff membership, clinical
20 privileges, or managed care network participation.
21 (k) Nothing in this Act shall be construed to prohibit
22 delegation of credentialing and recredentialing activities as
23 long as the delegated entity follows the requirements set
24 forth in this Act.
25 (l) Nothing in this Act shall be construed to require
26 any health care entity or health care plan to credential or
27 survey any health care professional.
28 (Source: P.A. 91-602, eff. 8-16-99.)
29 (410 ILCS 517/20)
30 Sec. 20. Single credentialing cycle.
31 (a) The Department, in consultation with the council,
32 shall by rule establish a single credentialing cycle. The
33 single credentialing cycle shall be based on a specific
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1 variable or variables. To the extent possible the single
2 credentialing cycle shall be established to ensure that the
3 credentials data of all health care professionals in a group
4 or at a single site are collected during the same time
5 period. However, nothing in this Act shall be construed to
6 require the single credentialing cycle to be established to
7 ensure that the credentials data of all health care
8 professionals in a group or at a single site are collected
9 during the same time period.
10 (b) Beginning July 1, 2002 January 1, 2001, all health
11 care entities and health care plans shall obtain credentials
12 data on all health care professionals according to the
13 established single credentialing cycle.
14 (c) The Department, in consultation with the council,
15 shall by rule establish a process to exempt a small or unique
16 health care entity or small or unique health care plan from
17 the single credentialing cycle if the health care entity or
18 health care plan demonstrates to the Department that
19 adherence to the single credentialing cycle would be an undue
20 hardship for the health care entity or health care plan.
21 (d) The requirements of this Section shall not apply
22 when a health care professional submits initial credentials
23 data to a health care entity or health care plan outside of
24 the established single credentialing cycle, when a health
25 care professional's credentials data change substantively, or
26 when a health care entity or health care plan requires
27 recredentialing as a result of patient or quality assurance
28 issues.
29 (Source: P.A. 91-602, eff. 8-16-99.)
30 (410 ILCS 517/25)
31 Sec. 25. Single site survey.
32 (a) The Department, in consultation with the council,
33 shall by rule establish a uniform site survey instrument
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1 taking into account national accreditation standards and
2 State requirements. The uniform site survey instrument shall
3 include all the site survey data requested by health care
4 entities and health care plans.
5 (b) No later than July 1, 2002 January 1, 2001, the
6 Department, in consultation with the council, shall publish,
7 in rule, the variable or variables for completing the single
8 site survey. To the extent possible, the single site survey
9 shall be established to ensure that all health care
10 professionals in a group or at a site are reviewed during the
11 same time period.
12 (c) Beginning January 1, 2003 July 1, 2001, health care
13 entities and health care plans shall implement the single
14 site survey, if a site survey is required by any of the
15 health care professional's health care entities or health
16 care plans. The site survey shall be completed using the
17 uniform site survey instrument.
18 (d) The uniform site survey instrument shall be used
19 when a health care professional seeks initial credentialing
20 by a health care entity or health care plan, when a health
21 care professional's credentials data change substantively, or
22 when a health care plan or health care entity requires a site
23 survey as a result of patient or quality assurance issues, if
24 a site survey is required by the health care entity or health
25 care plan.
26 (e) Nothing in this Section prohibits health care
27 entities and health care plans from choosing the independent
28 party to conduct the single site survey.
29 (Source: P.A. 91-602, eff. 8-16-99.)".