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Public Act 92-0193
HB1954 Enrolled LRB9200934ACcd
AN ACT to amend the Health Care Professional Credentials
Data Collection Act.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Health Care Professional Credentials Data
Collection Act is amended by changing Sections 15, 20, and 25
as follows:
(410 ILCS 517/15)
Sec. 15. Development and use of uniform health care and
hospital credentials forms.
(a) The Department, in consultation with the council,
shall by rule establish:
(1) a uniform health care credentials form that
shall include the credentials data commonly requested by
health care entities and health care plans for purposes
of credentialing and shall minimize the need for the
collection of additional credentials data;
(2) a uniform health care recredentials form that
shall include the credentials data commonly requested by
health care entities and health care plans for purposes
of recredentialing and shall minimize the need for the
collection of additional credentials data;
(3) a uniform hospital credentials form that shall
include the credentials data commonly requested by
hospitals for purposes of credentialing and shall
minimize the need for the collection of additional
credentials data;
(4) a uniform hospital recredentials form that
shall include the credentials data commonly requested by
hospitals for purposes of recredentialing and shall
minimize the need for collection of additional
credentials data; and
(5) uniform updating forms.
(b) The uniform forms established in subsection (a)
shall be coordinated to reduce the need to provide redundant
information. Further, the forms shall be made available in
both paper and electronic formats.
(c) The Department, in consultation with the council,
shall establish by rule a date after which an electronic
format may be required by a health care entity, a health care
plan, or a hospital, and a health care professional may
require acceptance of an electronic format by a health care
entity, a health care plan, or a hospital.
(d) Beginning January July 1, 2002 2000, each health
care entity or health care plan that employs, contracts with,
or allows health care professionals to provide medical or
health care services and requires health care professionals
to be credentialed or recredentialed shall for purposes of
collecting credentials data only require:
(1) the uniform health care credentials form;
(2) the uniform health care recredentials form;
(3) the uniform updating forms; and
(4) any additional credentials data requested.
(e) Beginning January July 1, 2002 2000, each hospital
that employs, contracts with, or allows health care
professionals to provide medical or health care services and
requires health care professionals to be credentialed or
recredentialed shall for purposes of collecting credentials
data only require:
(1) the uniform hospital credentials form;
(2) the uniform hospital recredentials form;
(3) the uniform updating forms; and
(4) any additional credentials data requested.
(f) Each health care entity and health care plan shall
complete the process of verifying a health care
professional's credentials data in a timely fashion and shall
complete the process of credentialing or recredentialing of
the health care professional within 60 days after submission
of all credentials data and completion of verification of the
credentials data.
(g) Each health care professional shall provide any
corrections, updates, and modifications to his or her
credentials data to ensure that all credentials data on the
health care professional remains current. Such corrections,
updates, and modifications shall be provided within 5
business days for State health care professional license
revocation, federal Drug Enforcement Agency license
revocation, Medicare or Medicaid sanctions, revocation of
hospital privileges, any lapse in professional liability
coverage required by a health care entity, health care plan,
or hospital, or conviction of a felony, and within 45 days
for any other change in the information from the date the
health care professional knew of the change. All updates
shall be made on the uniform updating forms developed by the
Department.
(h) Any credentials data collected or obtained by the
health care entity, health care plan, or hospital shall be
confidential, as provided by law, and otherwise may not be
redisclosed without written consent of the health care
professional, except that in any proceeding to challenge
credentialing or recredentialing, or in any judicial review,
the claim of confidentiality shall not be invoked to deny a
health care professional, health care entity, health care
plan, or hospital access to or use of credentials data.
Nothing in this Section prevents a health care entity, health
care plan, or hospital from disclosing any credentials data
to its officers, directors, employees, agents,
subcontractors, medical staff members, any committee of the
health care entity, health care plan, or hospital involved in
the credentialing process, or accreditation bodies or
licensing agencies. However, any redisclosure of credentials
data contrary to this Section is prohibited.
(i) Nothing in this Act shall be construed to restrict
the right of any health care entity, health care plan or
hospital to request additional information necessary for
credentialing or recredentialing.
(j) Nothing in this Act shall be construed to restrict
in any way the authority of any health care entity, health
care plan or hospital to approve, suspend or deny an
application for hospital staff membership, clinical
privileges, or managed care network participation.
(k) Nothing in this Act shall be construed to prohibit
delegation of credentialing and recredentialing activities as
long as the delegated entity follows the requirements set
forth in this Act.
(l) Nothing in this Act shall be construed to require
any health care entity or health care plan to credential or
survey any health care professional.
(Source: P.A. 91-602, eff. 8-16-99.)
(410 ILCS 517/20)
Sec. 20. Single credentialing cycle.
(a) The Department, in consultation with the council,
shall by rule establish a single credentialing cycle. The
single credentialing cycle shall be based on a specific
variable or variables. To the extent possible the single
credentialing cycle shall be established to ensure that the
credentials data of all health care professionals in a group
or at a single site are collected during the same time
period. However, nothing in this Act shall be construed to
require the single credentialing cycle to be established to
ensure that the credentials data of all health care
professionals in a group or at a single site are collected
during the same time period.
(b) Beginning July 1, 2002 January 1, 2001, all health
care entities and health care plans shall obtain credentials
data on all health care professionals according to the
established single credentialing cycle.
(c) The Department, in consultation with the council,
shall by rule establish a process to exempt a small or unique
health care entity or small or unique health care plan from
the single credentialing cycle if the health care entity or
health care plan demonstrates to the Department that
adherence to the single credentialing cycle would be an undue
hardship for the health care entity or health care plan.
(d) The requirements of this Section shall not apply
when a health care professional submits initial credentials
data to a health care entity or health care plan outside of
the established single credentialing cycle, when a health
care professional's credentials data change substantively, or
when a health care entity or health care plan requires
recredentialing as a result of patient or quality assurance
issues.
(Source: P.A. 91-602, eff. 8-16-99.)
(410 ILCS 517/25)
Sec. 25. Single site survey.
(a) The Department, in consultation with the council,
shall by rule establish a uniform site survey instrument
taking into account national accreditation standards and
State requirements. The uniform site survey instrument shall
include all the site survey data requested by health care
entities and health care plans.
(b) No later than July 1, 2002 January 1, 2001, the
Department, in consultation with the council, shall publish,
in rule, the variable or variables for completing the single
site survey. To the extent possible, the single site survey
shall be established to ensure that all health care
professionals in a group or at a site are reviewed during the
same time period.
(c) Beginning January 1, 2003 July 1, 2001, health care
entities and health care plans shall implement the single
site survey, if a site survey is required by any of the
health care professional's health care entities or health
care plans. The site survey shall be completed using the
uniform site survey instrument.
(d) The uniform site survey instrument shall be used
when a health care professional seeks initial credentialing
by a health care entity or health care plan, when a health
care professional's credentials data change substantively, or
when a health care plan or health care entity requires a site
survey as a result of patient or quality assurance issues, if
a site survey is required by the health care entity or health
care plan.
(e) Nothing in this Section prohibits health care
entities and health care plans from choosing the independent
party to conduct the single site survey.
(Source: P.A. 91-602, eff. 8-16-99.)
Passed in the General Assembly May 10, 2001.
Approved August 01, 2001.
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