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| [ Introduced ] | [ Enrolled ] | [ House Amendment 001 ] |
92_HB1954eng HB1954 Engrossed LRB9200934ACcd 1 AN ACT to amend the Health Care Professional Credentials 2 Data Collection Act. 3 Be it enacted by the People of the State of Illinois, 4 represented in the General Assembly: 5 Section 5. The Health Care Professional Credentials Data 6 Collection Act is amended by changing Sections 15, 20, and 25 7 as follows: 8 (410 ILCS 517/15) 9 Sec. 15. Development and use of uniform health care and 10 hospital credentials forms. 11 (a) The Department, in consultation with the council, 12 shall by rule establish: 13 (1) a uniform health care credentials form that 14 shall include the credentials data commonly requested by 15 health care entities and health care plans for purposes 16 of credentialing and shall minimize the need for the 17 collection of additional credentials data; 18 (2) a uniform health care recredentials form that 19 shall include the credentials data commonly requested by 20 health care entities and health care plans for purposes 21 of recredentialing and shall minimize the need for the 22 collection of additional credentials data; 23 (3) a uniform hospital credentials form that shall 24 include the credentials data commonly requested by 25 hospitals for purposes of credentialing and shall 26 minimize the need for the collection of additional 27 credentials data; 28 (4) a uniform hospital recredentials form that 29 shall include the credentials data commonly requested by 30 hospitals for purposes of recredentialing and shall 31 minimize the need for collection of additional HB1954 Engrossed -2- LRB9200934ACcd 1 credentials data; and 2 (5) uniform updating forms. 3 (b) The uniform forms established in subsection (a) 4 shall be coordinated to reduce the need to provide redundant 5 information. Further, the forms shall be made available in 6 both paper and electronic formats. 7 (c) The Department, in consultation with the council, 8 shall establish by rule a date after which an electronic 9 format may be required by a health care entity, a health care 10 plan, or a hospital, and a health care professional may 11 require acceptance of an electronic format by a health care 12 entity, a health care plan, or a hospital. 13 (d) Beginning JanuaryJuly1, 20022000, each health 14 care entity or health care plan that employs, contracts with, 15 or allows health care professionals to provide medical or 16 health care services and requires health care professionals 17 to be credentialed or recredentialed shall for purposes of 18 collecting credentials data only require: 19 (1) the uniform health care credentials form; 20 (2) the uniform health care recredentials form; 21 (3) the uniform updating forms; and 22 (4) any additional credentials data requested. 23 (e) Beginning JanuaryJuly1, 20022000, each hospital 24 that employs, contracts with, or allows health care 25 professionals to provide medical or health care services and 26 requires health care professionals to be credentialed or 27 recredentialed shall for purposes of collecting credentials 28 data only require: 29 (1) the uniform hospital credentials form; 30 (2) the uniform hospital recredentials form; 31 (3) the uniform updating forms; and 32 (4) any additional credentials data requested. 33 (f) Each health care entity and health care plan shall 34 complete the process of verifying a health care HB1954 Engrossed -3- LRB9200934ACcd 1 professional's credentials data in a timely fashion and shall 2 complete the process of credentialing or recredentialing of 3 the health care professional within 60 days after submission 4 of all credentials data and completion of verification of the 5 credentials data. 6 (g) Each health care professional shall provide any 7 corrections, updates, and modifications to his or her 8 credentials data to ensure that all credentials data on the 9 health care professional remains current. Such corrections, 10 updates, and modifications shall be provided within 5 11 business days for State health care professional license 12 revocation, federal Drug Enforcement Agency license 13 revocation, Medicare or Medicaid sanctions, revocation of 14 hospital privileges, any lapse in professional liability 15 coverage required by a health care entity, health care plan, 16 or hospital, or conviction of a felony, and within 45 days 17 for any other change in the information from the date the 18 health care professional knew of the change. All updates 19 shall be made on the uniform updating forms developed by the 20 Department. 21 (h) Any credentials data collected or obtained by the 22 health care entity, health care plan, or hospital shall be 23 confidential, as provided by law, and otherwise may not be 24 redisclosed without written consent of the health care 25 professional, except that in any proceeding to challenge 26 credentialing or recredentialing, or in any judicial review, 27 the claim of confidentiality shall not be invoked to deny a 28 health care professional, health care entity, health care 29 plan, or hospital access to or use of credentials data. 30 Nothing in this Section prevents a health care entity, health 31 care plan, or hospital from disclosing any credentials data 32 to its officers, directors, employees, agents, 33 subcontractors, medical staff members, any committee of the 34 health care entity, health care plan, or hospital involved in HB1954 Engrossed -4- LRB9200934ACcd 1 the credentialing process, or accreditation bodies or 2 licensing agencies. However, any redisclosure of credentials 3 data contrary to this Section is prohibited. 4 (i) Nothing in this Act shall be construed to restrict 5 the right of any health care entity, health care plan or 6 hospital to request additional information necessary for 7 credentialing or recredentialing. 8 (j) Nothing in this Act shall be construed to restrict 9 in any way the authority of any health care entity, health 10 care plan or hospital to approve, suspend or deny an 11 application for hospital staff membership, clinical 12 privileges, or managed care network participation. 13 (k) Nothing in this Act shall be construed to prohibit 14 delegation of credentialing and recredentialing activities as 15 long as the delegated entity follows the requirements set 16 forth in this Act. 17 (l) Nothing in this Act shall be construed to require 18 any health care entity or health care plan to credential or 19 survey any health care professional. 20 (Source: P.A. 91-602, eff. 8-16-99.) 21 (410 ILCS 517/20) 22 Sec. 20. Single credentialing cycle. 23 (a) The Department, in consultation with the council, 24 shall by rule establish a single credentialing cycle. The 25 single credentialing cycle shall be based on a specific 26 variable or variables. To the extent possible the single 27 credentialing cycle shall be established to ensure that the 28 credentials data of all health care professionals in a group 29 or at a single site are collected during the same time 30 period. However, nothing in this Act shall be construed to 31 require the single credentialing cycle to be established to 32 ensure that the credentials data of all health care 33 professionals in a group or at a single site are collected HB1954 Engrossed -5- LRB9200934ACcd 1 during the same time period. 2 (b) Beginning July 1, 2002January 1, 2001, all health 3 care entities and health care plans shall obtain credentials 4 data on all health care professionals according to the 5 established single credentialing cycle. 6 (c) The Department, in consultation with the council, 7 shall by rule establish a process to exempt a small or unique 8 health care entity or small or unique health care plan from 9 the single credentialing cycle if the health care entity or 10 health care plan demonstrates to the Department that 11 adherence to the single credentialing cycle would be an undue 12 hardship for the health care entity or health care plan. 13 (d) The requirements of this Section shall not apply 14 when a health care professional submits initial credentials 15 data to a health care entity or health care plan outside of 16 the established single credentialing cycle, when a health 17 care professional's credentials data change substantively, or 18 when a health care entity or health care plan requires 19 recredentialing as a result of patient or quality assurance 20 issues. 21 (Source: P.A. 91-602, eff. 8-16-99.) 22 (410 ILCS 517/25) 23 Sec. 25. Single site survey. 24 (a) The Department, in consultation with the council, 25 shall by rule establish a uniform site survey instrument 26 taking into account national accreditation standards and 27 State requirements. The uniform site survey instrument shall 28 include all the site survey data requested by health care 29 entities and health care plans. 30 (b) No later than July 1, 2002January 1, 2001, the 31 Department, in consultation with the council, shall publish, 32 in rule, the variable or variables for completing the single 33 site survey. To the extent possible, the single site survey HB1954 Engrossed -6- LRB9200934ACcd 1 shall be established to ensure that all health care 2 professionals in a group or at a site are reviewed during the 3 same time period. 4 (c) Beginning January 1, 2003July 1, 2001, health care 5 entities and health care plans shall implement the single 6 site survey, if a site survey is required by any of the 7 health care professional's health care entities or health 8 care plans. The site survey shall be completed using the 9 uniform site survey instrument. 10 (d) The uniform site survey instrument shall be used 11 when a health care professional seeks initial credentialing 12 by a health care entity or health care plan, when a health 13 care professional's credentials data change substantively, or 14 when a health care plan or health care entity requires a site 15 survey as a result of patient or quality assurance issues, if 16 a site survey is required by the health care entity or health 17 care plan. 18 (e) Nothing in this Section prohibits health care 19 entities and health care plans from choosing the independent 20 party to conduct the single site survey. 21 (Source: P.A. 91-602, eff. 8-16-99.)