SB365: Health care provider; SHHR to convene a work group related to credentialing.


VIRGINIA ACTS OF ASSEMBLY -- CHAPTER
An Act to direct the Secretary of Health and Human Resources to convene a work group related to health care provider credentialing.
[S 365]
Approved

 

Be it enacted by the General Assembly of Virginia:

1. § 1. That the Secretary of Health and Human Resources shall convene a work group to gather information and make recommendations on how the Commonwealth could develop or procure a statewide centralized primary source verification system that can be relied upon by the Commonwealth and its health carriers, health care providers, hospitals, and health systems for health care provider credentialing. Such stakeholders shall include the Virginia Association of Health Plans, the Medical Society of Virginia, the Virginia Council of Nurse Practitioners, the Virginia Hospital and Healthcare Association, and any other relevant stakeholders. The work group shall report its findings and recommendations to the Chairmen of the House Committee on Health, Welfare and Institutions and the Senate Committee on Education and Health by November 15, 2020.


SENATE BILL NO. 365
AMENDMENT IN THE NATURE OF A SUBSTITUTE
(Proposed by the Senate Committee on Education and Health
on January 23, 2020)
(Patron Prior to Substitute--Senator Dunnavant)
A BILL to direct the Secretary of Health and Human Resources to convene a work group related to health care provider credentialing.

Be it enacted by the General Assembly of Virginia:

1. § 1. That the Secretary of Health and Human Resources shall convene a work group to gather information and make recommendations on how the Commonwealth could develop or procure a statewide centralized primary source verification system that can be relied upon by the Commonwealth and its health carriers, health care providers, hospitals, and health systems for health care provider credentialing. Such stakeholders shall include the Virginia Association of Health Plans, the Medical Society of Virginia, the Virginia Hospital and Healthcare Association, and any other relevant stakeholders. The work group shall report its findings and recommendations to the Chairmen of the House Committee on Health, Welfare and Institutions and the Senate Committee on Education and Health by November 15, 2020.

SENATE BILL NO. 365

Offered January 8, 2020
Prefiled January 6, 2020
A BILL to direct the State Board of Health to promulgate regulations regarding the credentialing process for health care providers; health carriers and hospitals.
Patron-- Dunnavant

Referred to Committee on Education and Health

Be it enacted by the General Assembly of Virginia:

1. § 1. As used in this act:

"Covered person" means a policyholder, subscriber, enrollee, participant, or other individual covered by a health benefit plan.

"Health benefit plan" means a policy, contract, certificate, or agreement offered by a health carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services.

"Health carrier" means an entity subject to the insurance laws and regulations of the Commonwealth and subject to the jurisdiction of the State Corporation Commission that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services or mental health services, including an insurer licensed to sell accident and sickness insurance, a health maintenance organization, a health services plan, or any other entity providing a plan of health insurance, health benefits, health care services, or mental health services.

§ 2. The State Board of Health shall promulgate regulations requiring a health carrier to establish reasonable protocols and procedures that deem a provider credentialed who has been approved for credentialing by a licensed hospital within 14 days of such approval if such licensed hospital has a contract with the health carrier to provide health care services to a covered person under a health benefit plan offered by the health carrier as a member of the health benefit plan's network.