Senate Bill 2134

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    Florida Senate - 1999                                  SB 2134

    By Senator Saunders





    25-1155-99

  1                      A bill to be entitled

  2         An act to provide standardized credentialing

  3         for health care practitioners; amending s.

  4         455.557, F.S.; revising requirements;

  5         prohibiting a health care entity or credentials

  6         verification organization from collecting or

  7         attempting to collect duplicate core

  8         credentials data; providing a penalty for

  9         violating the prohibition; providing an

10         effective date.

11

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

13

14         Section 1.  Section 455.557, Florida Statutes, 1998

15  Supplement, is amended to read:

16         455.557  Standardized credentialing for health care

17  practitioners.--

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

19  efficient and effective health care practitioner credentialing

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

21  recognizes that health care practitioner credentialing

22  activities have increased significantly as a result of health

23  care reform and recent changes in health care delivery and

24  reimbursement systems. Moreover, the resulting duplication of

25  health care practitioner credentialing activities is

26  unnecessarily costly and cumbersome for both the practitioner

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

28  the intent of this section that a mandatory credentials

29  verification program be established which provides that, once

30  a health care practitioner's core credentials data are

31  collected, validated, maintained, and stored, they need not be

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  1  collected again. Mandatory credentialing under this section

  2  shall initially include those individuals licensed under

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

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

  5  applicable board, include other professions under the

  6  jurisdiction of the Division of Medical Quality Assurance in

  7  this credentialing program, provided they meet the

  8  requirements of s. 455.565.

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

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

11  Credentials Verification Advisory Council.

12         (b)  "Applicant" means an individual applying for

13  initial or renewal licensure or a current licensee applying

14  for credentialing.

15         (c)  "Certified" or "accredited," as applicable, means

16  approved by a quality assessment program, from the National

17  Committee for Quality Assurance, the Joint Commission on

18  Accreditation of Healthcare Organizations, the American

19  Accreditation HealthCare Commission/URAC Utilization Review

20  Accreditation Commission, or any such other nationally

21  recognized and accepted organization authorized by the

22  department, used to assess and certify any credentials

23  verification program, entity, or organization that verifies

24  the credentials of any health care practitioner.

25         (d)  The "required core credentials data" file for

26  current licensees includes current and former names and any

27  aliases, means any professional education, professional

28  training, peer references, licensure, current Drug Enforcement

29  Administration certification, social security number,

30  specialty board certification, Educational Commission for

31  Foreign Medical Graduates certification information, hospital

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  1  affiliations and staff status and dates of affiliation for

  2  each, managed care organization affiliations, other

  3  institutional affiliations and dates of affiliation for each,

  4  professional society memberships, evidence of professional

  5  liability coverage or evidence of financial responsibility as

  6  required by s. 458.320 or s. 459.0085 insurance, claims,

  7  suits, judgments, or settlements, and Medicare or Medicaid

  8  sanctions, civil or criminal law violations, practitioner

  9  profiling data, special conditions of impairment, or

10  regulatory exemptions not previously reported to the

11  department in accordance with both s. 455.565 and the initial

12  licensure reporting requirements specified in the applicable

13  practice act. Core credentials data required to be verified by

14  the department according to national standards include

15  professional education, professional training, licensure,

16  specialty board certification, and certification by the

17  Educational Commission for Foreign Medical Graduates

18  certification.

19         (e)  "Core credentials data" means the data included in

20  the required core credentials data for current licensees and

21  licensure core credentials data for licensure applicants.

22         (f)(e)  "Credentialing" means the process of assessing

23  and verifying validating the qualifications of a licensed

24  health care practitioner.

25         (g)(f)  "Credentials verification organization entity"

26  means any program, entity, or organization that is organized

27  and certified or accredited for the express purpose of

28  collecting, verifying, maintaining, storing, and providing to

29  health care entities a health care practitioner's total core

30  credentials data, including all corrections, updates, and

31  modifications thereto, as authorized by the health care

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  1  practitioner and in accordance with the provisions of this

  2  section. The division, once certified, shall be considered a

  3  credentials verification entity for all health care

  4  practitioners.

  5         (h)(g)  "Department" means the Department of Health.

  6         (i)(h)  "Designated credentials verification

  7  organization entity" means the program, entity, or

  8  organization organized and certified or accredited and

  9  registered with the department for the express purpose of

10  collecting, verifying, maintaining, storing, and providing to

11  health care entities a health care practitioner's total core

12  credentials data, including all corrections, updates, and

13  modifications thereto, which is selected by the health care

14  practitioner as the credentials verification entity for all

15  inquiries into his or her credentials, if the health care

16  practitioner chooses to make such a designation.

17  Notwithstanding any such designation by a health care

18  practitioner, the division, once certified, shall also be

19  considered a designated credentials verification entity for

20  that health care practitioner.

21         (j)(i)  "Division" means the Division of Medical

22  Quality Assurance within the Department of Health.

23         (k)  "Drug Enforcement Administration certification"

24  means evidence of current certification and the current

25  address to which the certificate is issued.

26         (l)(j)  "Health care entity" means:

27         1.  Any health care facility or other health care

28  organization licensed or certified to provide approved medical

29  and allied health services in Florida; or

30         2.  Any entity licensed by the Department of Insurance

31  as a prepaid health care plan or health maintenance

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  1  organization or as an insurer to provide coverage for health

  2  care services through a network of providers.

  3         (m)(k)  "Health care practitioner" means any person

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

  5  chapter 461 or any person licensed under a chapter

  6  subsequently made subject to this section by the department

  7  with the approval of the applicable board.

  8         (n)  "Hospital affiliations" means the name and address

  9  of the institution or institutions and the staff status and

10  dates of affiliation for each.

11         (o)  "Licensure core credentials data" means the data

12  required for initial licensure applicants under the applicable

13  practice act.

14         (p)(l)  "National accrediting organization" means an

15  organization that awards accreditation or certification to

16  hospitals, managed care organizations, credentials

17  verification organizations, or other health care

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

19  Commission on Accreditation of Healthcare Organizations, the

20  American Accreditation HealthCare Commission/URAC, and the

21  National Committee for Quality Assurance.

22         (q)  "Peer references" means the names and addresses of

23  three professional references, two of whom must currently

24  practice in the licensee's specialty, and all of whom can

25  attest to the licensee's current professional competence but

26  are not affiliated with the licensee's current practice.

27         (r)(m)  "Primary source verification" means

28  verification of professional qualifications based on evidence

29  obtained directly from the issuing source of the applicable

30  qualification.

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  1         (s)  "Professional training" means any internship,

  2  residency, or fellowship.

  3         (t)  "Recredentialing" means the updating and

  4  reverification, at specified intervals, of core credentials

  5  that may have expired or changed, which updating and

  6  reverification is performed to ensure continuing

  7  qualifications and competency process by which a credentials

  8  verification entity verifies the credentials of a health care

  9  practitioner whose core credentials data, including all

10  corrections, updates, and modifications thereto, are currently

11  on file with the entity.

12         (u)(o)  "Secondary source verification" means

13  confirmation of a professional qualification by means other

14  than primary source verification, as outlined and approved by

15  national accrediting organizations.

16         (v)  "Specialty board certification" means a current

17  and active certificate of specialization.

18         (3)  STANDARDIZED CREDENTIALS VERIFICATION PROGRAM.--

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

20  the department shall develop standardized forms and necessary

21  for the creation of a standardized system as well as

22  guidelines for collecting, verifying, maintaining, and

23  storing, and providing core credentials data and for releasing

24  it to health entities authorized by the on health care

25  practitioner to receive the data practitioners through

26  credentials verification entities, except as otherwise

27  provided in this section, for the purpose of eliminating

28  duplication. For initial licensure applicants, once the

29  licensure core credentials data are submitted to the

30  department, the applicant health care practitioner is not

31  required to resubmit this initial data when applying for

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  1  practice privileges with health care entities. Current

  2  licensees who have submitted to the department the required

  3  core credentials data file need not resubmit this data in

  4  applying for practice privileges with health care entities.

  5  However, as provided in paragraph (d), each health care

  6  practitioner or the practitioner's designee is responsible for

  7  providing to the department at least quarterly any

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

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

10  practitioner remains current. Nothing in this paragraph

11  prevents the designated credentials verification entity from

12  obtaining all necessary attestation and release form

13  signatures and dates.

14         (b)  There is established a Credentials Verification

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

16  development of guidelines for establishment of the

17  standardized credentials verification program. The secretary,

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

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

20  for any initial lesser term required to achieve staggering,

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

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

23  represent hospitals, and two members shall represent health

24  maintenance organizations. One member shall represent health

25  insurance entities. One member shall represent the credentials

26  verification industry. Two members shall represent physicians

27  licensed under chapter 458. One member shall represent

28  osteopathic physicians licensed under chapter 459. One member

29  shall represent chiropractic physicians licensed under chapter

30  460. One member shall represent podiatric physicians licensed

31  under chapter 461.

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

  2  council, shall develop standard forms for the initial

  3  reporting of core credentials data for credentialing purposes,

  4  for authorization by the practitioner for release of core

  5  credentials data, and for the subsequent reporting of

  6  corrections, updates, and modifications thereto for

  7  recredentialing purposes.

  8         (d)  Notwithstanding any other provision of this

  9  section, each health care practitioner licensed under chapter

10  458, chapter 459, chapter 460, or chapter 461, or any person

11  licensed under a chapter subsequently made subject to this

12  section, must meet all reporting requirements as specified in

13  the applicable practice act or in chapter 455. report any

14  action or information as defined in paragraph (2)(d),

15  including any correction, update, or modification thereto, as

16  soon as possible but not later than 30 days after such action

17  occurs or such information is known, to the department or his

18  or her designated credentials verification entity, if any, who

19  must report it to the department. In addition, a licensee must

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

21  prescribed by the department.

22         (e)  An individual applying for licensure under chapter

23  458, chapter 459, chapter 460, or chapter 461, or any person

24  applying for licensure under a chapter subsequently made

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

26  core credentials data to a credentials verification entity, if

27  such information has not already been submitted to the

28  department or the appropriate licensing board or to any other

29  credentials verification entity.

30         (e)(f)  A licensee must designate a applicants may

31  decide which credentials verification organization that he or

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  1  she wants entity they want to collect, verify, maintain,

  2  store, and provide his or her process and store their core

  3  credentials data; however, such data shall at all times be

  4  maintained by the department. However, a licensee An applicant

  5  may choose not to designate a credentials verification

  6  organization entity, provided the applicant has a written

  7  agreement with the health care entity or entities that are

  8  responsible for his or her credentialing. In addition, any

  9  licensee may choose to move his or her core credentials data

10  from one credentials verification organization entity to

11  another.

12         (g)  Any health care entity that employs, contracts

13  with, or allows health care practitioners to treat its

14  patients must use the designated credentials verification

15  entity to obtain core credentials data on a health care

16  practitioner applying for privileges with that entity, if the

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

18  use the division in lieu thereof as the designated credentials

19  verification entity required for obtaining core credentials

20  data on such health care practitioner. Any additional

21  information required by the health care entity's credentialing

22  process may be collected from the primary source of that

23  information either by the health care entity or its contractee

24  or by the designated credentials verification entity.

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

26  restrict the right of any health care entity to collect,

27  verify, maintain, and store a health care practitioner's core

28  data, including all corrections, updates, and modifications

29  thereto, as authorized by the health care practitioner for the

30  sole purpose of meeting the entity's internal credentialing

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  1  requirements request additional information necessary for

  2  credentialing.

  3         (i)  Nothing in this section may be construed to

  4  restrict access to the National Practitioner Data Bank by the

  5  department, any health care entity, or any credentials

  6  verification organization entity.

  7         (j)  Nothing in this section may be construed to

  8  restrict in any way the authority of the health care entity to

  9  approve or deny an application for hospital staff membership,

10  clinical privileges, or managed care network participation.

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

12  contract with any registered credentials verification

13  organization entity to perform the functions required under

14  this section. The submission of an application for health care

15  privileges with a health care entity shall constitute

16  authorization for the health care entity to access the

17  applicant's core credentials data with the department or the

18  applicant's designated credentials verification entity, if the

19  applicant has made such a designation.

20         (5)  AVAILABILITY OF DATA COLLECTED.--

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

22  care entity or registered credentials verification

23  organization entity registered with the department all core

24  credentials data it collects on any licensee that is otherwise

25  confidential and exempt from the provisions of chapter 119 and

26  s. 24(a), Art. I of the State Constitution, including

27  corrections, updates, and modifications thereto, if authorized

28  by the applicant or licensee a health care entity submits

29  proof of the licensee's current pending application for

30  purposes of credentialing the applicant based on the core

31  credentials data maintained by the department.

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  1         (b)  Each credentials verification organization entity

  2  shall make available to a health care entity the licensee has

  3  authorized to receive the data, and to the department at the

  4  credentials verification entity's actual cost of providing the

  5  data, all core credentials data it collects on any licensee,

  6  including all corrections, updates, and modifications thereto.

  7         (c)  The department shall charge health care entities

  8  and other credentials verification organizations the actual

  9  cost entities a reasonable fee, pursuant to the requirements

10  of chapter 119, to access all core credentialing data it

11  maintains on applicants and licensees. The actual cost fee

12  shall be determined set in consultation with the advisory

13  council and may not exceed the actual cost of providing the

14  data.

15         (6)  DUPLICATION OF DATA PROHIBITED.--

16         (a)  A health care entity or credentials verification

17  organization is prohibited from collecting or attempting to

18  collect may not collect or attempt to collect duplicate core

19  credentials data from any individual applicant or health care

20  practitioner or from any primary source if the information is

21  available from already on file with the department or with any

22  credentials verification organization entity. This section

23  does not restrict the right of any health care entity to

24  request additional information that is not included in the

25  core credentials data file but that the entity considers

26  necessary for credentialing for the entity's specific

27  purposes. Any additional information required by the health

28  care entity as part of the credentialing process may be

29  collected from the primary sources of that information either

30  by the health care entity or its contractee or by the

31  designated credentials verification organization. This

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  1  paragraph does not prevent the designated credentials

  2  verification organization from obtaining all necessary

  3  attestation and release form signatures and dates.

  4         (b)  Effective July 1, 2002, a state agency may not

  5  collect or attempt to collect duplicate core credentials data

  6  from any individual health care practitioner if the

  7  information is already available from the department. This

  8  section does not restrict the right of any state agency to

  9  request additional information that is not included in the

10  core credentials data file but that the agency considers

11  necessary for the agency's specific credentialing purposes. A

12  credentials verification entity other than the department may

13  not attempt to collect duplicate core credentials data from

14  any individual health care practitioner if the information is

15  already on file with another credentials verification entity

16  or with the appropriate licensing board of another state,

17  provided the other state's credentialing program meets

18  national standards and is certified or accredited, as outlined

19  by national accrediting organizations, and agrees to provide

20  all data collected under such program on that health care

21  practitioner.

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

23  entity may rely upon core credentials data, including all

24  corrections, updates, and modifications thereto, from the

25  department if the department certifies that the information

26  was obtained in accordance with primary source verification

27  procedures; and the department may rely upon core credentials

28  data, including all corrections, updates, and modifications

29  thereto, from any credentials verification entity if the

30  designated credentials verification entity certifies that the

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  1  information was obtained in accordance with primary source

  2  verification procedures.

  3         (7)(8)  STANDARDS AND REGISTRATION.--

  4         (a)  The department's credentials verification

  5  procedures must meet national standards, as outlined by

  6  national accrediting organizations.

  7         (b)  Any credentials verification organization entity

  8  that does business in Florida must be fully accredited or

  9  certified as a credentials verification organization meet

10  national standards, as outlined by a national accrediting

11  organization as specified in paragraph (2)(c) organizations,

12  and must register with the department. The department may

13  charge a reasonable registration fee, set in consultation with

14  the advisory council, not to exceed an amount sufficient to

15  cover its actual expenses in providing for and enforcing such

16  registration. The failure by a registered Any credentials

17  verification organization entity that fails to maintain full

18  accreditation or certification, meet the standards required to

19  be certified or accredited, fails to register with the

20  department, or fails to provide data to an entity as

21  authorized by the collected on a health care practitioner, or

22  to comply with the prohibition against collection of duplicate

23  core credentials data from a practitioner may result in a

24  denial of an application for registration or in the revocation

25  or suspension of a registration may not be selected as the

26  designated credentials verification entity for any health care

27  practitioner.

28         (8)(9)  LIABILITY.--No civil, criminal, or

29  administrative action may be instituted, and there shall be no

30  liability, against any health care entity on account of its

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  1  reliance on any data obtained from the department or a

  2  registered credentials verification organization entity.

  3         (9)(10)  REVIEW.--Before releasing a health care

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

  5  designated credentials verification entity other than the

  6  department must provide the practitioner up to 30 days to

  7  review such data and request reconsideration or resolution of

  8  errors in, or omissions of, data collected during the

  9  credentials verification process make any corrections of fact.

10         (10)(11)  VERIFICATION VALIDATION OF CREDENTIALS

11  DATA.--Except as otherwise acceptable to the health care

12  entity and applicable certifying or accrediting organization

13  listed in paragraph (2)(c), the department and all credentials

14  verification entities must perform primary source verification

15  of all credentialing information submitted to them pursuant to

16  this section; however, secondary source verification may be

17  utilized if there is a documented attempt to contact primary

18  sources. The primary- and secondary-source verification

19  validation procedures used by the department and registered

20  credentials verification organizations entities must meet the

21  standards established by rule, in consultation with the

22  advisory council, pursuant to this section.

23         (11)(12)  LIABILITY INSURANCE REQUIREMENTS.--The

24  department, in consultation with the Credentials Verification

25  Advisory Council, shall establish the minimum liability

26  insurance requirements for each credentials verification

27  organization entity doing business in this state.

28         (12)(13)  RULES.--The department, in consultation with

29  the advisory council applicable board, shall adopt rules

30  necessary to develop and implement the standardized

31  credentials verification program established by this section.

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  1         Section 2.  Except as otherwise expressly provided in

  2  this act, this act shall take effect July 1, 1999.

  3

  4            *****************************************

  5                          SENATE SUMMARY

  6    Revises requirements pertaining to standardized
      credentialing for health care practitioners. Effective
  7    July 1, 2002, prohibits a health care entity or
      credentials verification organization from collecting or
  8    attempting to collect core credentials data that
      duplicates information that is available from the
  9    department or any credentials verification organization.
      Provides a penalty for violating the prohibition.
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