SENATE BILL No. 610

 

 

September 7, 2011, Introduced by Senators CASWELL, PAPPAGEORGE and PROOS and referred to the Committee on Health Policy.

 

 

 

     A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

(MCL 333.1101 to 333.25211) by adding section 16285.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 16285. (1) By not later than 9 months after the effective

 

date of this section, the department shall develop a uniform,

 

standard, electronic health care professional credentialing

 

application. The department shall make the credentialing

 

application available free of charge to health insurers, health

 

care corporations, health maintenance organizations, and health

 

facilities and agencies and shall make the application available on

 

its internet website. In developing the credentialing application

 

under this section, the department shall consult with health care

 

professionals, health insurers, health care corporations, health

 


maintenance organizations, and health facilities and agencies and

 

shall consider their reasonable requirements, including, but not

 

limited to, all of the following:

 

     (a) Statutory credentialing requirements.

 

     (b) The need to eliminate multiple proprietary credentialing

 

applications.

 

     (c) Providing an efficient, electronic, cost-effective health

 

care professional database through which health care professionals

 

can provide notification of changes in address, practice-related

 

information, qualifications, and other pertinent information.

 

     (d) Time frames within which entities requiring credentialing

 

applications shall respond to applications filed by health care

 

professionals.

 

     (e) Maintaining the confidentiality of credentialing

 

information.

 

     (f) The need for a health care professional to control the

 

distribution of his or her credentialing application.

 

     (2) By not later than 365 days after the effective date of

 

this section, a health insurer, health care corporation, health

 

maintenance organization, or health facility or agency that

 

requires a health care professional to undergo a credentialing or

 

recrendentialing process, or the entity's credentialing

 

intermediary, shall use the credentialing application developed

 

under this section, except that this subsection does not apply to

 

any credentialing or recrendentialing that has already been

 

submitted before or on that date.

 

     (3) This section does not prevent a health insurer, health

 


care corporation, health maintenance organization, health facility

 

or agency, or credentialing intermediary from requesting

 

information in addition to that contained in the credentialing

 

application so long as any requests for additional information are

 

made in writing or electronically and use a form for the health

 

care professional to comply with the request that is separate from

 

the credentialing application form.

 

     (4) A health insurer, health care corporation, health

 

maintenance organization, health facility or agency, or

 

credentialing intermediary shall not charge a health care

 

professional a fee for use or submission of the credentialing

 

application or for completion of requests for additional

 

information under subsection (3).

 

     (5) The department shall review the standard credentialing

 

application no less frequently than every 5 years and may modify

 

the contents and format as determined necessary and appropriate.

 

     (6) As used in this section, "credentialing intermediary"

 

means a person to which a health insurer, health care corporation,

 

health maintenance organization, or health facility or agency has

 

delegated credentialing, recrendentialing, or primary source

 

verification process.

 

     Enacting section 1. This amendatory act does not take effect

 

unless Senate Bill No. 609                                        

 

          of the 96th Legislature is enacted into law.