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92_SB2077
LRB9214833DJgc
1 AN ACT in relation to health.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Health Care Professional Credentials Data
5 Collection Act is amended by changing Section 15 as follows:
6 (410 ILCS 517/15)
7 Sec. 15. Development and use of uniform health care and
8 hospital credentials forms.
9 (a) The Department, in consultation with the council,
10 shall by rule establish:
11 (1) a uniform health care credentials form that
12 shall include the credentials data commonly requested by
13 health care entities and health care plans for purposes
14 of credentialing and shall minimize the need for the
15 collection of additional credentials data;
16 (2) a uniform health care recredentials form that
17 shall include the credentials data commonly requested by
18 health care entities and health care plans for purposes
19 of recredentialing and shall minimize the need for the
20 collection of additional credentials data;
21 (3) a uniform hospital credentials form that shall
22 include the credentials data commonly requested by
23 hospitals for purposes of credentialing and shall
24 minimize the need for the collection of additional
25 credentials data;
26 (4) a uniform hospital recredentials form that
27 shall include the credentials data commonly requested by
28 hospitals for purposes of recredentialing and shall
29 minimize the need for collection of additional
30 credentials data; and
31 (5) uniform updating forms.
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1 (b) The uniform forms established in subsection (a)
2 shall be coordinated to reduce the need to provide redundant
3 information. Further, the forms shall be made available in
4 both paper and electronic formats.
5 (c) The Department, in consultation with the council,
6 shall establish by rule a date after which an electronic
7 format may be required by a health care entity, a health care
8 plan, or a hospital, and a health care professional may
9 require acceptance of an electronic format by a health care
10 entity, a health care plan, or a hospital.
11 (d) Beginning January 1, 2002, each health care entity
12 or health care plan that employs, contracts with, or allows
13 health care professionals to provide medical or health care
14 services and requires health care professionals to be
15 credentialed or recredentialed shall for purposes of
16 collecting credentials data only require:
17 (1) the uniform health care credentials form;
18 (2) the uniform health care recredentials form;
19 (3) the uniform updating forms; and
20 (4) any additional credentials data requested.
21 (e) Beginning January 1, 2002, each hospital that
22 employs, contracts with, or allows health care professionals
23 to provide medical or health care services and requires
24 health care professionals to be credentialed or
25 recredentialed shall for purposes of collecting credentials
26 data only require:
27 (1) the uniform hospital credentials form;
28 (2) the uniform hospital recredentials form;
29 (3) the uniform updating forms; and
30 (4) any additional credentials data requested.
31 (f) Each health care entity and health care plan shall
32 complete the process of verifying a health care
33 professional's credentials data in a timely fashion and shall
34 complete the process of credentialing or recredentialing of
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1 the health care professional within 60 days after submission
2 of all credentials data and completion of verification of the
3 credentials data.
4 (g) Each health care professional shall provide any
5 corrections, updates, and modifications to his or her
6 credentials data to ensure that all credentials data on the
7 health care professional remains current. Such corrections,
8 updates, and modifications shall be provided within 5
9 business days for State health care professional license
10 revocation, federal Drug Enforcement Agency license
11 revocation, Medicare or Medicaid sanctions, revocation of
12 hospital privileges, any lapse in professional liability
13 coverage required by a health care entity, health care plan,
14 or hospital, or conviction of a felony, and within 45 days
15 for any other change in the information from the date the
16 health care professional knew of the change. All updates
17 shall be made on the uniform updating forms developed by the
18 Department.
19 (h) Any credentials data collected or obtained by the
20 health care entity, health care plan, or hospital shall be
21 confidential, as provided by law, and otherwise may not be
22 redisclosed without written consent of the health care
23 professional, except that in any proceeding to challenge
24 credentialing or recredentialing, or in any judicial review,
25 the claim of confidentiality shall not be invoked to deny a
26 health care professional, health care entity, health care
27 plan, or hospital access to or use of credentials data.
28 Nothing in this Section prevents a health care entity, health
29 care plan, or hospital from disclosing any credentials data
30 to its officers, directors, employees, agents,
31 subcontractors, medical staff members, any committee of the
32 health care entity, health care plan, or hospital involved in
33 the credentialing process, or accreditation bodies or
34 licensing agencies. However, any redisclosure of credentials
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1 data contrary to this Section is prohibited.
2 (i) Nothing in this Act shall be construed to restrict
3 the right of any health care entity, health care plan or
4 hospital to request additional information necessary for
5 credentialing or recredentialing.
6 (j) Nothing in this Act shall be construed to restrict
7 in any way the authority of any health care entity, health
8 care plan or hospital to approve, suspend or deny an
9 application for hospital staff membership, clinical
10 privileges, or managed care network participation.
11 (k) Nothing in this Act shall be construed to prohibit
12 delegation of credentialing and recredentialing activities as
13 long as the delegated entity follows the requirements set
14 forth in this Act.
15 (l) Nothing in this Act shall be construed to require
16 any health care entity or health care plan to credential or
17 survey any health care professional.
18 (m) Nothing in this Act shall be construed to prohibit a
19 hospital from obtaining credentialing data more than once
20 every 2 years for a health care professional who (i) has been
21 granted provisional, temporary, or probationary medical staff
22 membership, privileges, or status under the hospital's
23 medical staff bylaws, (ii) is disciplined under the
24 hospital's medical staff bylaws, or (iii) is impaired. As
25 used in this subsection (m), "impaired" means the inability
26 to practice medicine with reasonable skill and safety due to
27 one or more physical or mental disabilities as evidenced by a
28 written determination or written consent based on clinical
29 evidence, including deterioration through the aging process
30 or loss of motor skill, or abuse of drugs or alcohol, of
31 sufficient degree to diminish a person's ability to deliver
32 competent patient care.
33 (Source: P.A. 91-602, eff. 8-16-99; 92-193, eff. 1-1-02.)
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1 Section 99. Effective date. This Act takes effect upon
2 becoming law.