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Public Act 103-0096 | ||||
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AN ACT concerning health.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Health Care Professional Credentials Data | ||||
Collection Act is amended by changing Section 5 as follows:
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(410 ILCS 517/5)
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Sec. 5. Definitions. As used in this Act:
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"Council" means the Health Care Credentials Council.
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"Credentials data" means those data, information, or | ||||
answers to questions
required by a health care entity, health
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care plan, or hospital to complete the credentialing or
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recredentialing of a health care professional.
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"Credentialing" means the process of assessing and | ||||
validating the
qualifications of a health care professional.
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"Department" means the Department of Public Health.
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"Director" means the Director of the Department of Public | ||||
Health.
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"Health care entity" means any of the following which | ||||
require the submission
of credentials data: (i) a health care | ||||
facility or other
health care organization licensed or | ||||
certified to provide medical or
health services in Illinois, | ||||
other than a hospital; (ii) a health care
professional | ||||
partnership, corporation, limited liability company, |
professional
services corporation or group practice; or (iii) | ||
an independent
practice association or physician hospital | ||
organization. Nothing in this
definition shall be construed to | ||
mean that a hospital is a health care
entity.
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"Health care plan" means any entity licensed by the | ||
Department of Insurance
as a prepaid health care plan or | ||
health maintenance
organization or as an insurer
which | ||
requires the submission of
credentials data.
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"Health care professional" means any person licensed under | ||
the Medical
Practice Act of 1987 or any person licensed under | ||
any
other Act subsequently made subject to this Act by the | ||
Department.
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"Hospital" means a hospital licensed under the Hospital | ||
Licensing Act or any
hospital organized under the University | ||
of Illinois
Hospital Act.
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"Recredentialing" means a the process undertaken for a | ||
period not to exceed 3 years by which a health care entity, | ||
health
care plan or hospital ensures that a health care | ||
professional
who is currently credentialed by the health care | ||
entity, health care plan or
hospital continues to meet the | ||
credentialing criteria used by the
health care entity, health | ||
care plan, or hospital no more than once every 2
years .
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"Single credentialing cycle" means a process undertaken | ||
for a period not to exceed 3 years whereby for purposes of
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recredentialing each health care professional's credentials
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data are collected by all health care entities and health care |
plans that
credential the health care professional during the | ||
same time period and
only once every 2 years .
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"Site survey" means a process by which a health care | ||
entity or health care
plan assesses the office locations and | ||
medical record
keeping practices of a health care | ||
professional.
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"Single site survey" means a process by which, for | ||
purposes of
recredentialing, each health care professional | ||
receives a site visit only
once every two years.
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"Uniform health care credentials form" means the form | ||
developed by the
Department under Section 15 to collect the | ||
credentials
data commonly requested by health care entities | ||
and health care plans for
purposes of credentialing.
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"Uniform health care recredentials form" means the form | ||
developed by the
Department under Section 15 to collect the | ||
credentials data commonly requested
by health care entities | ||
and health care plans for purposes of
recredentialing.
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"Uniform hospital credentials form" means the form | ||
developed by the
Department
under Section 15 to collect the | ||
credentials data
commonly requested by hospitals for purposes | ||
of credentialing.
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"Uniform hospital recredentials form" means the form | ||
developed by the
Department under Section 15 to collect the | ||
credentials data commonly requested
by
hospitals for purposes | ||
of recredentialing.
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"Uniform site survey instrument" means the instrument |
developed by the
Department under Section 25 to complete a | ||
single site
survey as part of a credentialing or | ||
recredentialing process.
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"Uniform updating form" means a standardized form for | ||
reporting of
corrections,
updates, and modifications to | ||
credentials data to
health care entities, health care plans, | ||
and hospitals when those data change
following credentialing | ||
or recredentialing of a health care
professional.
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(Source: P.A. 91-602, eff. 8-16-99.)
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