H. B. 3242
(By Delegates Douglas, Kuhn, Perdue, Marshall, Ennis, Flanigan
and Ellem)
(Originating in the Committee on Government Organization)
[April 3, 2001 ]
A BILL 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.
§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
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 or recredentialing or
updating information and to specify the health care practitioners
who may make use of 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 of the six members
shall represent a hospital with one hundred beds or less; one of
the six members shall represent a hospital with more than one
hundred beds; one of the six members shall represent another type
of health care facility requiring credentialing; one of the six
members shall be a person currently credentialing on behalf of
health care practitioners; and two of the six members shall
represent the health care practitioners subject to credentialing.
Five members shall be appointed by the insurance commissioner and shall be representative of the entities regulated by the
insurance commissioner that require credentialing. One of the
five members shall represent an indemnity health care insurer;
one of the members shall represent a preferred provider
organization; one of the five members shall represent a third
party administrator; one of the five members shall represent a
health maintenance organization accredited by American
accreditation health care commission; and one of the five members
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 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.
Article one-a is new; therefore underscoring and strike-
throughs have been omitted.