House Bill 4515

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    Florida House of Representatives - 1998                HB 4515

        By the Committee on Health Care Standards & Regulatory
    Reform and Representatives Jones and Brooks





  1                      A bill to be entitled

  2         An act relating to health care practitioners;

  3         creating s. 455.557, F.S.; providing for

  4         standardized credentialing of health care

  5         practitioners; providing intent and

  6         definitions; providing for a standardized

  7         credentials verification program; providing for

  8         delegation of credentialing authority by

  9         contract; providing for availability of data

10         collected; prohibiting collection of duplicate

11         data; specifying conditions for reliability of

12         data; providing for standards and registration,

13         including a registration fee; preserving health

14         care entities from liability and certain

15         actions for reliance on data provided by a

16         credentials verification entity; providing for

17         practitioner review of data prior to release;

18         providing for validation of credentials;

19         providing liability insurance requirements;

20         providing for rules; providing for

21         reappointment of a task force and providing its

22         purpose; providing an effective date.

23

24  Be It Enacted by the Legislature of the State of Florida:

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26         Section 1.  Section 455.557, Florida Statutes, is

27  created to read:

28         455.557  Standardized credentialing for health care

29  practitioners.--

30         (1)  INTENT.--The Legislature recognizes that an

31  efficient and effective health care practitioner credentialing

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  1  program helps to ensure access to quality health care and also

  2  recognizes that health care practitioner credentialing

  3  activities have increased significantly as a result of health

  4  care reform and recent changes in health care delivery and

  5  reimbursement systems. Moreover, the resulting duplication of

  6  health care practitioner credentialing activities is

  7  unnecessarily costly and cumbersome for both the practitioner

  8  and the entity granting practice privileges. Therefore, it is

  9  the intent of this section that a mandatory credentials

10  verification program be established which provides that, once

11  a health care practitioner's core credentials data are

12  collected, validated, maintained, and stored, they need never

13  be collected again. Mandatory credentialing under this section

14  shall initially include those individuals licensed under

15  chapter 458, chapter 459, chapter 460, or chapter 461.

16  However, the department shall, with the approval of the

17  applicable board, include other professions under the

18  jurisdiction of the Division of Medical Quality Assurance in

19  this credentialing program, provided they meet the

20  requirements of s. 455.565.

21         (2)  DEFINITIONS.--As used in this section, the term:

22         (a)  "Advisory council" or "council" means the

23  Credentials Verification Advisory Council.

24         (b)  "Certified" means approved by a quality assessment

25  program, from the National Committee for Quality Assurance,

26  the Joint Commission on Accreditation of Healthcare

27  Organizations, or any such other national accreditation

28  organization authorized by the department, used to assess and

29  certify any credentials verification program, entity, or

30  organization that verifies the credentials of any health care

31  practitioner.

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  1         (c)  "Core credentials data" means any professional

  2  education, professional training, peer references, licensure,

  3  Drug Enforcement Administration certification, social security

  4  number, board certification, Educational Commission for

  5  Foreign Medical Graduates information, hospital affiliations,

  6  managed care organization affiliations, other institutional

  7  affiliations, professional society memberships, professional

  8  liability insurance, claims, suits, judgments, or settlements,

  9  Medicare or Medicaid sanctions, civil or criminal law

10  violations, practitioner profiling data, special conditions of

11  impairment, or regulatory exemptions not previously reported

12  to the department in accordance with both s. 455.565 and the

13  initial licensure reporting requirements specified in the

14  applicable practice act.

15         (d)  "Credentialing" means the process of assessing and

16  validating the qualifications of a licensed health care

17  practitioner.

18         (e)  "Credentials verification entity" means any

19  program, entity, or organization that is organized and

20  certified for the express purpose of collecting, verifying,

21  maintaining, storing, and providing to health care entities a

22  health care practitioner's total core credentials data,

23  including all corrections, updates, and modifications thereto,

24  as authorized by the health care practitioner and in

25  accordance with the provisions of this section. The division,

26  once certified, shall be considered a credentials verification

27  entity for all health care practitioners.

28         (f)  "Department" means the Department of Health.

29         (g)  "Designated credentials verification entity" means

30  the program, entity, or organization organized and certified

31  for the express purpose of collecting, verifying, maintaining,

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  1  storing, and providing to health care entities a health care

  2  practitioner's total core credentials data, including all

  3  corrections, updates, and modifications thereto, which is

  4  selected by the health care practitioner as the credentials

  5  verification entity for all inquiries into his or her

  6  credentials, if the health care practitioner chooses to make

  7  such a designation. Notwithstanding any such designation by a

  8  health care practitioner, the division shall also be

  9  considered a designated credentials verification entity for

10  that health care practitioner.

11         (h)  "Division" means the Division of Medical Quality

12  Assurance within the Department of Health.

13         (i)  "Health care entity" means:

14         1.  Any health care facility or other health care

15  organization licensed or certified to provide approved medical

16  and allied health services in Florida; or

17         2.  Any entity licensed by the Department of Insurance

18  as a prepaid health care plan or health maintenance

19  organization or as an insurer to provide coverage for health

20  care services through a network of providers.

21         (j)  "Health care practitioner" means any person

22  licensed under chapter 458, chapter 459, chapter 460, or

23  chapter 461 or any person licensed under a chapter

24  subsequently made subject to this section by the department

25  with the approval of the applicable board.

26         (k)  "National accrediting organization" means an

27  organization that awards accreditation or certification to

28  hospitals, managed care organizations, or other health care

29  organizations, including, but not limited to, the Joint

30  Commission on Accreditation of Healthcare Organizations and

31  the National Committee for Quality Assurance.

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  1         (l)  "Primary source verification" means verification

  2  of professional qualifications based on evidence obtained

  3  directly from the issuing source of the applicable

  4  qualification.

  5         (m)  "Recredentialing" means the process by which a

  6  credentials verification entity verifies the credentials of a

  7  health care practitioner whose core credentials data,

  8  including all corrections, updates, and modifications thereto,

  9  are currently on file with the entity.

10         (n)  "Secondary source verification" means confirmation

11  of a professional qualification by means other than primary

12  source verification, as outlined and approved by national

13  accrediting organizations.

14         (3)  STANDARDIZED CREDENTIALS VERIFICATION PROGRAM.--

15         (a)  In accordance with the provisions of this section,

16  the department shall develop guidelines for the creation of a

17  standardized system, including standardized forms, for

18  collecting, verifying, maintaining, storing, and providing

19  core credentials data on health care practitioners through

20  credentials verification entities, except as otherwise

21  provided in this section, for the purpose of eliminating

22  duplication. Once the core credentials data are submitted, the

23  health care practitioner is not required to resubmit this

24  initial data when applying for practice privileges with health

25  care entities. However, as provided in paragraph (d), each

26  health care practitioner is responsible for providing any

27  corrections, updates, and modifications to his or her core

28  credentials data, to ensure that all credentialing data on the

29  practitioner remains current. Nothing in this paragraph

30  prevents the designated credentials verification entity from

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  1  obtaining all necessary attestation and release form

  2  signatures and dates.

  3         (b)  There is established a Credentials Verification

  4  Advisory Council, consisting of 13 members, to assist with the

  5  development of guidelines for establishment of the

  6  standardized credentials verification program. The secretary,

  7  or his or her designee, shall serve as one member and chair of

  8  the council and shall appoint the remaining 12 members. Except

  9  for any initial lesser term required to achieve staggering,

10  such appointments shall be for 4-year staggered terms, with

11  one 4-year reappointment, as applicable. Three members shall

12  represent hospitals, and two members shall represent health

13  maintenance organizations. One member shall represent health

14  insurance entities. One member shall represent the credentials

15  verification industry. Two members shall represent physicians

16  licensed under chapter 458, one member shall represent

17  osteopathic physicians licensed under chapter 459, one member

18  shall represent chiropractic physicians licensed under chapter

19  460, and one member shall represent podiatric physicians

20  licensed under chapter 461.

21         (c)  The department, in consultation with the advisory

22  council, shall develop standard forms for the initial

23  reporting of core credentials data for credentialing purposes

24  and for the subsequent reporting of corrections, updates, and

25  modifications thereto for recredentialing purposes.

26         (d)  Each health care practitioner licensed under

27  chapter 458, chapter 459, chapter 460, or chapter 461, or any

28  person licensed under a chapter subsequently made subject to

29  this section, must report any action or information as defined

30  in paragraph (2)(c), including any correction, update, or

31  modification thereto, to the department and his or her

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  1  designated credentials verification entity, if any, as soon as

  2  possible but not later than 30 days after such action occurs

  3  or such information is known. In addition, a licensee must

  4  update, at least quarterly, his or her data on a form

  5  prescribed by the department.

  6         (e)  An individual applying for licensure under chapter

  7  458, chapter 459, chapter 460, or chapter 461, or any person

  8  applying for licensure under a chapter subsequently made

  9  subject to this section, must submit the individual's initial

10  core credentials data to a credentials verification entity, if

11  such information has not already been submitted to the

12  department or the appropriate licensing board or to any other

13  credentials verification entity. Applicants may decide which

14  credentials verification entity they want to process and store

15  their core credentials data; however, such data shall at all

16  times be maintained by the department. An applicant may choose

17  not to designate a credentials verification entity, provided

18  the applicant has a written agreement with the health care

19  entity or entities that are responsible for his or her

20  credentialing. In addition, any licensee may choose to move

21  his or her core credentials data from one credentials

22  verification entity to another.

23         (f)  Any health care entity that employs, contracts

24  with, or allows health care practitioners to treat its

25  patients must use the designated credentials verification

26  entity to obtain core credentials data on a health care

27  practitioner applying for privileges with that entity, if the

28  health care practitioner has made such a designation, or may

29  use the division in lieu thereof as the designated credentials

30  verification entity required for obtaining core credentials

31  data on such health care practitioner. Any additional

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  1  information required by the health care entity's credentialing

  2  process may be collected from the primary source of that

  3  information either by the health care entity or its contractee

  4  or by the designated credentials verification entity.

  5         (g)  Nothing in this section may be construed to

  6  restrict the right of any health care entity to request

  7  additional information necessary for credentialing.

  8         (h)  Nothing in this section may be construed to

  9  restrict access to the National Practitioner Data Bank by the

10  department, any health care entity, or any credentials

11  verification entity.

12         (4)  DELEGATION BY CONTRACT.--A health care entity may

13  contract with any credentials verification entity to perform

14  the functions required under this section. The submission of

15  an application for health care privileges with a health care

16  entity shall constitute authorization for the health care

17  entity to access the applicant's core credentials data with

18  the department or the applicant's designated credentials

19  verification entity, if the applicant has made such a

20  designation.

21         (5)  AVAILABILITY OF DATA COLLECTED.--

22         (a)  The department shall make available to a health

23  care entity or credentials verification entity all core

24  credentials data it collects on any licensee, including any

25  corrections, updates, and modifications thereto, provided the

26  licensee authorizes the release of the information.

27         (b)  Each credentials verification entity shall make

28  available to a health care entity, and to the department at

29  the credentials verification entity's actual cost of providing

30  the data, all core credentials data it collects on any

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  1  licensee, including all corrections, updates, and

  2  modifications thereto.

  3         (c)  The department shall charge health care entities

  4  and other credentials verification entities a reasonable fee

  5  to access all credentialing data it maintains on applicants

  6  and licensees. The fee shall be set in consultation with the

  7  advisory council and may not exceed the actual cost of

  8  providing the data.

  9         (6)  DUPLICATION OF DATA PROHIBITED.--

10         (a)  A health care entity may not collect or attempt to

11  collect duplicate core credentials data from any individual

12  health care practitioner or from any primary source if the

13  information is already on file with the department or with any

14  credentials verification entity.

15         (b)  Neither the department nor any credentials

16  verification entity may attempt to collect duplicate core

17  credentials data from any individual health care practitioner

18  or from any primary source other than the department if the

19  information is already on file with another credentials

20  verification entity or with the appropriate licensing board of

21  another state, provided the other state's credentialing

22  program meets national standards and is certified, as outlined

23  by national accrediting organizations, and agrees to provide

24  all data collected under such program on that health care

25  practitioner.

26         (7)  RELIABILITY OF DATA.--Any credentials verification

27  entity may rely upon core credentials data, including all

28  corrections, updates, and modifications thereto, from the

29  department if the department certifies that the information

30  was obtained in accordance with certified primary source

31  verification procedures; and the department may rely upon core

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  1  credentials data, including all corrections, updates, and

  2  modifications thereto, from any credentials verification

  3  entity if the designated credentials verification entity

  4  certifies that the information was obtained in accordance with

  5  certified primary source verification procedures.

  6         (8)  STANDARDS AND REGISTRATION.--

  7         (a)  The department's credentials verification

  8  procedures must meet national standards, as outlined by

  9  national accrediting organizations.

10         (b)  Any credentials verification entity that does

11  business in Florida must meet national standards, as outlined

12  by national accrediting organizations, and must register with

13  the department. The department may charge a reasonable

14  registration fee, not to exceed an amount sufficient to cover

15  its actual expenses in providing for such registration. Any

16  credentials verification entity that fails to meet the

17  standards required to be certified, fails to register with the

18  department, or fails to provide data collected on a health

19  care practitioner may not be selected as the designated

20  credentials verification entity for any health care

21  practitioner.

22         (9)  LIABILITY.--No civil, criminal, or administrative

23  action may be instituted, and there shall be no liability,

24  against any health care entity on account of its reliance on

25  any data obtained from a credentials verification entity.

26         (10)  REVIEW.--Before releasing a health care

27  practitioner's core credentials data from its data bank, a

28  designated credentials verification entity must provide the

29  practitioner up to 30 days to review such data and make any

30  corrections of fact.

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  1         (11)  VALIDATION OF CREDENTIALS.--The department and

  2  all credentials verification entities must perform primary

  3  source verification of all credentialing information submitted

  4  to them pursuant to this section; however, secondary source

  5  verification may be utilized if there is a documented attempt

  6  to contact primary sources. The validation procedures used by

  7  the department and credentials verification entities must meet

  8  the standards established by rule pursuant to this section.

  9         (12)  LIABILITY INSURANCE REQUIREMENTS.--The

10  department, in consultation with the Credentials Verification

11  Advisory Council, shall establish the minimum liability

12  insurance requirements for each credentials verification

13  entity doing business in this state.

14         (13)  RULES.--The department, in consultation with the

15  applicable board, shall adopt rules necessary to develop and

16  implement the standardized credentials verification program

17  established by this section.

18         Section 2.  The Secretary of Health shall reappoint the

19  task force appointed under section 103 of chapter 97-261, Laws

20  of Florida. The reappointed task force shall develop

21  procedures to expand the standardized credentialing program

22  under section 455.557, Florida Statutes, as created by this

23  act, to include site visits.

24         Section 3.  This act shall take effect July 1, 1999.

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  1            *****************************************

  2                          HOUSE SUMMARY

  3
      Provides for standardized credentialing of health care
  4    practitioners. Provides intent and definitions. Provides
      for establishment by the Department of Health, in
  5    conjunction with an advisory council, of a standardized
      credentials verification program. Provides for delegation
  6    of credentialing authority by contract. Provides for
      availability of data collected. Prohibits collection of
  7    duplicate data. Specifies conditions for reliability of
      data. Provides for standards and registration with the
  8    department, including a registration fee. Preserves
      health care entities from liability and certain actions
  9    for reliance on data provided by a credentials
      verification entity. Provides for practitioner review of
10    data prior to release. Provides for verification of
      credentials. Provides liability insurance requirements.
11    Provides for rules. Provides for reappointment of a task
      force to develop procedures to expand the standardized
12    credentialing program to include site visits. See bill
      for details.
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