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.