ENROLLED
H. B. 3242
(By Delegates Douglas, Kuhn, Perdue, Marshall, Ennis, Flanigan
and Ellem)
[Passed April 14, 2001; in effect ninety days from passage.]
AN ACT to amend chapter sixteen of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, by adding
thereto a new article, designated article one-a, relating to
uniform credentialing for health care practitioners.
Be it enacted by the Legislature of West Virginia:
That chapter sixteen of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, be amended by
adding thereto a new article, designated article one-a, to read
as follows:
ARTICLE 1A. UNIFORM CREDENTIALING FOR HEALTH CARE PRACTITIONERS.
§16-1A -1. Legislative findings; purpose.
(a) The legislature finds:
(1) Credentialing, required by hospitals, insurance
companies, prepaid health plans, third party administrators and other health care entities, is necessary to assess and verify the
education, training, experience and competence of health care
practitioners to ensure that qualified professionals treat the
citizens of this state.
(2) Currently, each of the entities requiring credentialing
has its own credentialing application forms resulting in health
care practitioners being required to complete multiple forms
listing the same or similar information. The duplication is
costly, time consuming and not in the best interests of the
citizens of this state.
(3) The secretary of the department of health and human
resources and the insurance commissioner share regulatory
authority over the entities requiring credentialing.
(b) The purpose of this article is to authorize the
development of uniform credentialing application forms by those
public officials regulating the entities that require
credentialing and to establish an advisory committee to assist in
developing a uniform credentialing process and implementing the
use of uniform credentialing in this state.
§16-1A-2. Development of uniform credentialing application forms.
Notwithstanding any provision of this code to the contrary,
the secretary of the department of health and human resources and the insurance commissioner, on or before the first day of
January, two thousand two, shall jointly propose rules for
legislative approval in accordance with the provisions of article
three, chapter twenty-nine-a of this code which set forth uniform
application forms for credentialing, recredentialing or updating
information and to specify the health care practitioners who may
utilize the forms.
§16-1A-3. Advisory committee.
The secretary of the department of health and human
resources and the insurance commissioner shall jointly establish
an advisory committee to assist them in the development and
implementation of the uniform credentialing process in this
state. The advisory committee shall consist of eleven appointed
members. Six members shall be appointed by the secretary of the
department of health and human resources: one member shall
represent a hospital with one hundred beds or less; one member
shall represent a hospital with more than one hundred beds; one
member shall represent another type of health care facility
requiring credentialing; one member shall be a person currently
credentialing on behalf of health care practitioners; and two of
the members shall represent the health care practitioners subject
to credentialing. Five members shall be representative of the entities regulated by the insurance commissioner that require
credentialing and shall be appointed by the insurance
commissioner: one member shall represent an indemnity health care
insurer; one member shall represent a preferred provider
organization; one member shall represent a third party
administrator; one member shall represent a health maintenance
organization accredited by American accreditation health care
commission; and one member shall represent a health maintenance
organization accredited by the national committee on quality
assurance. The secretary of the department of health and human
resources and the insurance commissioner, or the designee of
either or both, shall be non-voting ex officio members.
§16-1A-4. Report required.
On or before the first day of January, two thousand two, the
secretary of the department of health and human resources and the
insurance commissioner shall jointly report to the legislative
oversight commission on health and human resources accountability
on the need, if any, for further legislation to implement the use
of the uniform credentialing application forms developed pursuant
to the legislative rule authorized by section two of this
article.
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