103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2221 Introduced 2/10/2023, by Sen. Laura Fine SYNOPSIS AS INTRODUCED: 410 ILCS 517/5 410 ILCS 517/15 410 ILCS 517/20 410 ILCS 517/25 410 ILCS 517/30 410 ILCS 517/35 410 ILCS 517/10 rep. Amends the Health Care Professional Credentials Data Collection Act. Provides that "recredentialing" and "single credentialing cycle" must be undertaken for a period not to exceed 3 years (rather than once every 2 years). Provides that forms established by the Department of Public Health under the provisions shall be available in both paper and electronic formats upon request and in the format requested (rather than just in both paper and electronic formats). Repeals provisions establishing the Health Care Credentials Council and makes conforming changes. LRB103 27111 CPF 53479 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2221 Introduced 2/10/2023, by Sen. Laura Fine SYNOPSIS AS INTRODUCED: 410 ILCS 517/5 410 ILCS 517/15 410 ILCS 517/20 410 ILCS 517/25 410 ILCS 517/30 410 ILCS 517/35 410 ILCS 517/10 rep. 410 ILCS 517/5 410 ILCS 517/15 410 ILCS 517/20 410 ILCS 517/25 410 ILCS 517/30 410 ILCS 517/35 410 ILCS 517/10 rep. Amends the Health Care Professional Credentials Data Collection Act. Provides that "recredentialing" and "single credentialing cycle" must be undertaken for a period not to exceed 3 years (rather than once every 2 years). Provides that forms established by the Department of Public Health under the provisions shall be available in both paper and electronic formats upon request and in the format requested (rather than just in both paper and electronic formats). Repeals provisions establishing the Health Care Credentials Council and makes conforming changes. LRB103 27111 CPF 53479 b LRB103 27111 CPF 53479 b A BILL FOR
103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2221 Introduced 2/10/2023, by Sen. Laura Fine SYNOPSIS AS INTRODUCED:
410 ILCS 517/5 410 ILCS 517/15 410 ILCS 517/20 410 ILCS 517/25 410 ILCS 517/30 410 ILCS 517/35 410 ILCS 517/10 rep. 410 ILCS 517/5 410 ILCS 517/15 410 ILCS 517/20 410 ILCS 517/25 410 ILCS 517/30 410 ILCS 517/35 410 ILCS 517/10 rep.
410 ILCS 517/5
410 ILCS 517/15
410 ILCS 517/20
410 ILCS 517/25
410 ILCS 517/30
410 ILCS 517/35
410 ILCS 517/10 rep.
Amends the Health Care Professional Credentials Data Collection Act. Provides that "recredentialing" and "single credentialing cycle" must be undertaken for a period not to exceed 3 years (rather than once every 2 years). Provides that forms established by the Department of Public Health under the provisions shall be available in both paper and electronic formats upon request and in the format requested (rather than just in both paper and electronic formats). Repeals provisions establishing the Health Care Credentials Council and makes conforming changes.
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A BILL FOR
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SB2221 LRB103 27111 CPF 53479 b
1 AN ACT concerning health.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Health Care Professional Credentials Data
5 Collection Act is amended by changing Sections 5, 15, 20, 25,
6 30, and 35 as follows:
7 (410 ILCS 517/5)
8 Sec. 5. Definitions. As used in this Act:
9 "Council" means the Health Care Credentials Council.
10 "Credentials data" means those data, information, or
11 answers to questions required by a health care entity, health
12 care plan, or hospital to complete the credentialing or
13 recredentialing of a health care professional.
14 "Credentialing" means the process of assessing and
15 validating the qualifications of a health care professional.
16 "Department" means the Department of Public Health.
17 "Director" means the Director of the Department of Public
18 Health.
19 "Health care entity" means any of the following which
20 require the submission of credentials data: (i) a health care
21 facility or other health care organization licensed or
22 certified to provide medical or health services in Illinois,
23 other than a hospital; (ii) a health care professional
103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2221 Introduced 2/10/2023, by Sen. Laura Fine SYNOPSIS AS INTRODUCED:
410 ILCS 517/5 410 ILCS 517/15 410 ILCS 517/20 410 ILCS 517/25 410 ILCS 517/30 410 ILCS 517/35 410 ILCS 517/10 rep. 410 ILCS 517/5 410 ILCS 517/15 410 ILCS 517/20 410 ILCS 517/25 410 ILCS 517/30 410 ILCS 517/35 410 ILCS 517/10 rep.
410 ILCS 517/5
410 ILCS 517/15
410 ILCS 517/20
410 ILCS 517/25
410 ILCS 517/30
410 ILCS 517/35
410 ILCS 517/10 rep.
Amends the Health Care Professional Credentials Data Collection Act. Provides that "recredentialing" and "single credentialing cycle" must be undertaken for a period not to exceed 3 years (rather than once every 2 years). Provides that forms established by the Department of Public Health under the provisions shall be available in both paper and electronic formats upon request and in the format requested (rather than just in both paper and electronic formats). Repeals provisions establishing the Health Care Credentials Council and makes conforming changes.
LRB103 27111 CPF 53479 b LRB103 27111 CPF 53479 b
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A BILL FOR
410 ILCS 517/5
410 ILCS 517/15
410 ILCS 517/20
410 ILCS 517/25
410 ILCS 517/30
410 ILCS 517/35
410 ILCS 517/10 rep.
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1 partnership, corporation, limited liability company,
2 professional services corporation or group practice; or (iii)
3 an independent practice association or physician hospital
4 organization. Nothing in this definition shall be construed to
5 mean that a hospital is a health care entity.
6 "Health care plan" means any entity licensed by the
7 Department of Insurance as a prepaid health care plan or
8 health maintenance organization or as an insurer which
9 requires the submission of credentials data.
10 "Health care professional" means any person licensed under
11 the Medical Practice Act of 1987 or any person licensed under
12 any other Act subsequently made subject to this Act by the
13 Department.
14 "Hospital" means a hospital licensed under the Hospital
15 Licensing Act or any hospital organized under the University
16 of Illinois Hospital Act.
17 "Recredentialing" means a the process undertaken for a
18 period not to exceed 3 years by which a health care entity,
19 health care plan or hospital ensures that a health care
20 professional who is currently credentialed by the health care
21 entity, health care plan or hospital continues to meet the
22 credentialing criteria used by the health care entity, health
23 care plan, or hospital no more than once every 2 years.
24 "Single credentialing cycle" means a process undertaken
25 for a period not to exceed 3 years whereby for purposes of
26 recredentialing each health care professional's credentials
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1 data are collected by all health care entities and health care
2 plans that credential the health care professional during the
3 same time period and only once every 2 years.
4 "Site survey" means a process by which a health care
5 entity or health care plan assesses the office locations and
6 medical record keeping practices of a health care
7 professional.
8 "Single site survey" means a process by which, for
9 purposes of recredentialing, each health care professional
10 receives a site visit only once every two years.
11 "Uniform health care credentials form" means the form
12 developed by the Department under Section 15 to collect the
13 credentials data commonly requested by health care entities
14 and health care plans for purposes of credentialing.
15 "Uniform health care recredentials form" means the form
16 developed by the Department under Section 15 to collect the
17 credentials data commonly requested by health care entities
18 and health care plans for purposes of recredentialing.
19 "Uniform hospital credentials form" means the form
20 developed by the Department under Section 15 to collect the
21 credentials data commonly requested by hospitals for purposes
22 of credentialing.
23 "Uniform hospital recredentials form" means the form
24 developed by the Department under Section 15 to collect the
25 credentials data commonly requested by hospitals for purposes
26 of recredentialing.
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1 "Uniform site survey instrument" means the instrument
2 developed by the Department under Section 25 to complete a
3 single site survey as part of a credentialing or
4 recredentialing process.
5 "Uniform updating form" means a standardized form for
6 reporting of corrections, updates, and modifications to
7 credentials data to health care entities, health care plans,
8 and hospitals when those data change following credentialing
9 or recredentialing of a health care professional.
10 (Source: P.A. 91-602, eff. 8-16-99.)
11 (410 ILCS 517/15)
12 Sec. 15. Development and use of uniform health care and
13 hospital credentials forms.
14 (a) The Department, in consultation with the council,
15 shall by rule establish:
16 (1) a uniform health care credentials form that shall
17 include the credentials data commonly requested by health
18 care entities and health care plans for purposes of
19 credentialing and shall minimize the need for the
20 collection of additional credentials data;
21 (2) a uniform health care recredentials form that
22 shall include the credentials data commonly requested by
23 health care entities and health care plans for purposes of
24 recredentialing and shall minimize the need for the
25 collection of additional credentials data;
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1 (3) a uniform hospital credentials form that shall
2 include the credentials data commonly requested by
3 hospitals for purposes of credentialing and shall minimize
4 the need for the collection of additional credentials
5 data;
6 (4) a uniform hospital recredentials form that shall
7 include the credentials data commonly requested by
8 hospitals for purposes of recredentialing and shall
9 minimize the need for collection of additional credentials
10 data; and
11 (5) uniform updating forms.
12 (b) The uniform forms established by the Department under
13 this Section in subsection (a) shall be coordinated to reduce
14 the need to provide redundant information. Further, the forms
15 shall be made available in both paper and electronic formats
16 upon request and in the format requested.
17 (c) The Department, in consultation with the council,
18 shall establish by rule a date after which an electronic
19 format may be required by a health care entity, a health care
20 plan, or a hospital, and a health care professional may
21 require acceptance of an electronic format by a health care
22 entity, a health care plan, or a hospital.
23 (d) Beginning January 1, 2002, each health care entity or
24 health care plan that employs, contracts with, or allows
25 health care professionals to provide medical or health care
26 services and requires health care professionals to be
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1 credentialed or recredentialed shall for purposes of
2 collecting credentials data only require:
3 (1) the uniform health care credentials form;
4 (2) the uniform health care recredentials form;
5 (3) the uniform updating forms; and
6 (4) any additional credentials data requested.
7 (e) Beginning January 1, 2002, each hospital that employs,
8 contracts with, or allows health care professionals to provide
9 medical or health care services and requires health care
10 professionals to be credentialed or recredentialed shall for
11 purposes of collecting credentials data only require:
12 (1) the uniform hospital credentials form;
13 (2) the uniform hospital recredentials form;
14 (3) the uniform updating forms; and
15 (4) any additional credentials data requested.
16 (f) Each health care entity and health care plan shall
17 complete the process of verifying a health care professional's
18 credentials data in a timely fashion and shall complete the
19 process of credentialing or recredentialing of the health care
20 professional within 60 days after submission of all
21 credentials data and completion of verification of the
22 credentials data.
23 (g) Each health care professional shall provide any
24 corrections, updates, and modifications to his or her
25 credentials data to ensure that all credentials data on the
26 health care professional remains current. Such corrections,
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1 updates, and modifications shall be provided within 5 business
2 days for State health care professional license revocation,
3 federal Drug Enforcement Agency license revocation, Medicare
4 or Medicaid sanctions, revocation of hospital privileges, any
5 lapse in professional liability coverage required by a health
6 care entity, health care plan, or hospital, or conviction of a
7 felony, and within 45 days for any other change in the
8 information from the date the health care professional knew of
9 the change. All updates shall be made on the uniform updating
10 forms developed by the Department.
11 (h) Any credentials data collected or obtained by the
12 health care entity, health care plan, or hospital shall be
13 confidential, as provided by law, and otherwise may not be
14 redisclosed without written consent of the health care
15 professional, except that in any proceeding to challenge
16 credentialing or recredentialing, or in any judicial review,
17 the claim of confidentiality shall not be invoked to deny a
18 health care professional, health care entity, health care
19 plan, or hospital access to or use of credentials data.
20 Nothing in this Section prevents a health care entity, health
21 care plan, or hospital from disclosing any credentials data to
22 its officers, directors, employees, agents, subcontractors,
23 medical staff members, any committee of the health care
24 entity, health care plan, or hospital involved in the
25 credentialing process, or accreditation bodies or licensing
26 agencies. However, any redisclosure of credentials data
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1 contrary to this Section is prohibited.
2 (i) Nothing in this Act shall be construed to restrict the
3 right of any health care entity, health care plan or hospital
4 to request additional information necessary for credentialing
5 or recredentialing.
6 (j) Nothing in this Act shall be construed to restrict in
7 any way the authority of any health care entity, health care
8 plan or hospital to approve, suspend or deny an application
9 for hospital staff membership, clinical privileges, or managed
10 care network participation.
11 (k) Nothing in this Act shall be construed to prohibit
12 delegation of credentialing and recredentialing activities as
13 long as the delegated entity follows the requirements set
14 forth in this Act.
15 (l) Nothing in this Act shall be construed to require any
16 health care entity or health care plan to credential or survey
17 any health care professional.
18 (m) Nothing in this Act prohibits a hospital from granting
19 disaster privileges pursuant to the provisions of Section 10.4
20 of the Hospital Licensing Act. When a hospital grants disaster
21 privileges pursuant to Section 10.4 of the Hospital Licensing
22 Act, that hospital is not required to collect credentials data
23 pursuant to this Act.
24 (Source: P.A. 92-193, eff. 1-1-02; 93-829, eff. 7-28-04.)
25 (410 ILCS 517/20)
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1 Sec. 20. Single credentialing cycle.
2 (a) The Department, in consultation with the council,
3 shall by rule establish a single credentialing cycle. The
4 single credentialing cycle shall be based on a specific
5 variable or variables. To the extent possible the single
6 credentialing cycle shall be established to ensure that the
7 credentials data of all health care professionals in a group
8 or at a single site are collected during the same time period.
9 However, nothing in this Act shall be construed to require the
10 single credentialing cycle to be established to ensure that
11 the credentials data of all health care professionals in a
12 group or at a single site are collected during the same time
13 period.
14 (b) Beginning July 1, 2002, all health care entities and
15 health care plans shall obtain credentials data on all health
16 care professionals according to the established single
17 credentialing cycle.
18 (c) The Department, in consultation with the council,
19 shall by rule establish a process to exempt a small or unique
20 health care entity or small or unique health care plan from the
21 single credentialing cycle if the health care entity or health
22 care plan demonstrates to the Department that adherence to the
23 single credentialing cycle would be an undue hardship for the
24 health care entity or health care plan.
25 (d) The requirements of this Section shall not apply when
26 a health care professional submits initial credentials data to
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1 a health care entity or health care plan outside of the
2 established single credentialing cycle, when a health care
3 professional's credentials data change substantively, or when
4 a health care entity or health care plan requires
5 recredentialing as a result of patient or quality assurance
6 issues.
7 (Source: P.A. 91-602, eff. 8-16-99; 92-193, eff. 1-1-02.)
8 (410 ILCS 517/25)
9 Sec. 25. Single site survey.
10 (a) The Department, in consultation with the council,
11 shall by rule establish a uniform site survey instrument
12 taking into account national accreditation standards and State
13 requirements. The uniform site survey instrument shall include
14 all the site survey data requested by health care entities and
15 health care plans.
16 (b) No later than July 1, 2002, the Department, in
17 consultation with the council, shall publish, in rule, the
18 variable or variables for completing the single site survey.
19 To the extent possible, the single site survey shall be
20 established to ensure that all health care professionals in a
21 group or at a site are reviewed during the same time period.
22 (c) Beginning January 1, 2003, health care entities and
23 health care plans shall implement the single site survey, if a
24 site survey is required by any of the health care
25 professional's health care entities or health care plans. The
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1 site survey shall be completed using the uniform site survey
2 instrument.
3 (d) The uniform site survey instrument shall be used when
4 a health care professional seeks initial credentialing by a
5 health care entity or health care plan, when a health care
6 professional's credentials data change substantively, or when
7 a health care plan or health care entity requires a site survey
8 as a result of patient or quality assurance issues, if a site
9 survey is required by the health care entity or health care
10 plan.
11 (e) Nothing in this Section prohibits health care entities
12 and health care plans from choosing the independent party to
13 conduct the single site survey.
14 (Source: P.A. 91-602, eff. 8-16-99; 92-193, eff. 1-1-02.)
15 (410 ILCS 517/30)
16 Sec. 30. Study of coordinated credentials verification.
17 (a) The Department, in consultation with the council,
18 shall study the need for coordinated credentials data
19 verification.
20 (b) The study shall address the need for, the advantages
21 and disadvantages of, and the costs and cost savings, if any,
22 of coordinated credentials verification.
23 (c) The study also may address other changes to improve
24 the credentialing and recredentialing processes, to improve
25 the timeliness of the credentials data, and reduce the costs,
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1 time, and administrative burden associated with the processes.
2 (d) The Department shall make a recommendation to the
3 General Assembly and the Governor regarding the need for
4 further legislation no later than January 1, 2003.
5 (Source: P.A. 91-602, eff. 8-16-99.)
6 (410 ILCS 517/35)
7 Sec. 35. Rules. The Department, in consultation with the
8 council, shall adopt rules necessary to develop and implement
9 and enforce the requirements established by this Act.
10 (Source: P.A. 91-602, eff. 8-16-99.)
11 (410 ILCS 517/10 rep.)
12 Section 10. The Health Care Professional Credentials Data
13 Collection Act is amended by repealing Section 10.
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