Public Act 103-0096

Public Act 0096 103RD GENERAL ASSEMBLY

  
  
  

 


 
Public Act 103-0096
 
SB1617 EnrolledLRB103 25020 CPF 52743 b

    AN ACT concerning health.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Health Care Professional Credentials Data
Collection Act is amended by changing Section 5 as follows:
 
    (410 ILCS 517/5)
    Sec. 5. Definitions. As used in this Act:
    "Council" means the Health Care Credentials Council.
    "Credentials data" means those data, information, or
answers to questions required by a health care entity, health
care plan, or hospital to complete the credentialing or
recredentialing of a health care professional.
    "Credentialing" means the process of assessing and
validating the qualifications of a health care professional.
    "Department" means the Department of Public Health.
    "Director" means the Director of the Department of Public
Health.
    "Health care entity" means any of the following which
require the submission of credentials data: (i) a health care
facility or other health care organization licensed or
certified to provide medical or health services in Illinois,
other than a hospital; (ii) a health care professional
partnership, corporation, limited liability company,
professional services corporation or group practice; or (iii)
an independent practice association or physician hospital
organization. Nothing in this definition shall be construed to
mean that a hospital is a health care entity.
    "Health care plan" means any entity licensed by the
Department of Insurance as a prepaid health care plan or
health maintenance organization or as an insurer which
requires the submission of credentials data.
    "Health care professional" means any person licensed under
the Medical Practice Act of 1987 or any person licensed under
any other Act subsequently made subject to this Act by the
Department.
    "Hospital" means a hospital licensed under the Hospital
Licensing Act or any hospital organized under the University
of Illinois Hospital Act.
    "Recredentialing" means a the process undertaken for a
period not to exceed 3 years by which a health care entity,
health care plan or hospital ensures that a health care
professional who is currently credentialed by the health care
entity, health care plan or hospital continues to meet the
credentialing criteria used by the health care entity, health
care plan, or hospital no more than once every 2 years.
    "Single credentialing cycle" means a process undertaken
for a period not to exceed 3 years whereby for purposes of
recredentialing each health care professional's credentials
data are collected by all health care entities and health care
plans that credential the health care professional during the
same time period and only once every 2 years.
    "Site survey" means a process by which a health care
entity or health care plan assesses the office locations and
medical record keeping practices of a health care
professional.
    "Single site survey" means a process by which, for
purposes of recredentialing, each health care professional
receives a site visit only once every two years.
    "Uniform health care credentials form" means the form
developed by the Department under Section 15 to collect the
credentials data commonly requested by health care entities
and health care plans for purposes of credentialing.
    "Uniform health care recredentials form" means the form
developed by the Department under Section 15 to collect the
credentials data commonly requested by health care entities
and health care plans for purposes of recredentialing.
    "Uniform hospital credentials form" means the form
developed by the Department under Section 15 to collect the
credentials data commonly requested by hospitals for purposes
of credentialing.
    "Uniform hospital recredentials form" means the form
developed by the Department under Section 15 to collect the
credentials data commonly requested by hospitals for purposes
of recredentialing.
    "Uniform site survey instrument" means the instrument
developed by the Department under Section 25 to complete a
single site survey as part of a credentialing or
recredentialing process.
    "Uniform updating form" means a standardized form for
reporting of corrections, updates, and modifications to
credentials data to health care entities, health care plans,
and hospitals when those data change following credentialing
or recredentialing of a health care professional.
(Source: P.A. 91-602, eff. 8-16-99.)