Current through Register Vol. 49, No. 9, September, 2024
Click here
to view image
subject to this act, including not less than two (2)
hospital representatives and not less than two (2) insurer or health
maintenance organization representatives.
(4)
Credentialing information shall
not be disclosed to any parties other than the applicable health care provider
and the credentialing organization and its designated credentialing and
appeals, peer review and quality improvement committee(s) or body(ies). Except
as permitted herein, credentialing information shall not be used for any
purpose other than review by the board and credentialing organizations of the
professional background, competency, qualifications and credentials or renewal
of credentials of a health care provide?-, or appeals therefi-om, and all such
credentialing information shall be exempt from disclosure under the provisions
of Arkansas Code §§
25-19-101
through
25-19-107.
Credentialing information may be disclosed in the following
circumstances:
(A)
By the
board, in disciplinary hearings before the board or in any trial or appeal of
the board action or order.
(B)
By the board or credentialing
organization, to any licensing, regulatory or disciplinaiy authorities or
agencies of the United States or of other states or
jurisdictions.
(C)
In any legal or regulatory proceeding which:
(i)
is brought by a health care
provider; a representative of the health care provider or a class thereof; any
local, state or federal agency or authority; or a patient or group or class of
patients or their authorized representatives or agents; and
(ii)
challenges the actions,
omissions or conduct of the credentialing organization with respect to
credentialing of any health care provider or the grant or denial of any
affiliation or participation of such health care provider with or in the
credentialing organization or any network thereof; or
(D)
By any party when
authorized to do so by the health care provider to whom the credentialing
information relates.
(5)
The evaluation and discussion of
credentialing information by a credentialing organization shall not be subject
to discovery or admissible pursuant to the Arkansas Rules of Civil Procedure or
the Freedom of Information Act, beginning at §
25-19-101.
(6)
The board may enter into
contractual agreements with users of the credentialing information system to
define the type and form of information to be provided and to give users
assurances of the integrity of the information collected.
(7)
The board may charge
credentialing organizations a reasonable fee for the use of the credentialing
service as established by rule and regulation. The fee shall be set in
consultation with the advisory committee and shall be set at such a rate as
will reimburse the board, when added to the credentialing assessments collected
from physicians, for the cost of maintaining the credentialing information
system. The board's costs may not exceed the fees charged by private vendors
with a comparable statewide credentialing service. Each physician licensee of
the Arkansas State Medical board will pay a credentialing fee of one hundred
dollars ($100.00) per year at the time of the renewal of the license for the
year 2000 and 2001. For the year 2002 and each year thereafter, the board may
assess each physician licensee an amount not to exceed twenty-five dollars
($25.00) per year to offset the cost for providing the credentialing service.
Physicians shall not be charged a credentialing fee by a credentialing
organization.
(e)
(1)
In lieu of testing credentialing
information by its own primary source verification procedure, a credentialing
organization may rely upon credentialing information fiom the board, if the
board certifies that the information provided by the board has been tested by
the board's primary source verification procedure. The credentialing
organization shall be immune fi-om civil suit based on any allegation of
wrongdoing or negligence involved in the collection and verification of or
reliance upon, credentialing information on a health care provider if the
credentialing organization has utilized the information provided by the board
in credentialing a health care provider for affiliation or participation with
the credentialing organization. This does not convey immunity from civil suit
to a credentialing organization for any credentialing decision it
makes.
(2)
Subject
only to the exceptions recognized in subsections (f)(1) and (f)(2) hereof a
credentialing organization shall be precluded hereby from seeking credentialing
information from the physician or from sources other than the board
if:
(A)
the same
credentialing information is available from the board; and
(B)
at the time such credentialing
information is requested, the board:
(i)
holds certification by the
National Committee for Quality Assurance as a certified credentials
verification organization; and
(ii)
demonstrates compliance with the
principles for credentials verification organizations set forth by the Joint
Commission on the Accreditation of Healthcare Organizations;
(iii)
documents compliance with the
Arkansas Department of Health Rules and Regulations applicable to
credentialing; and
(iv)
maintains evidence of compliance with the standards referenced in (i),
(ii), and (iii) above; and
(C)
the board charges fees which
comply with (d)(7) above. Until such time as the board satisfies each of the
foregoing prerequisites, credentialing organizations may, in their discretion,
utilize credentialing information obtained from the board or they may seek
other sources for the same credentialing information. If at any time the board
fails to satisfy any of the certification or compliance standards referenced in
this subsection, no credentialing organization shall be required to utilize the
board to obtain credentialing information during any period in which the board
lacks such accreditation or compliance.
(f)
(1)
Credentialing organizations which
utilize the credentialing information system offered by the Arkansas State
Medical board shall not attempt to collect duplicate information from
individual physicians or originating sources, but nothing herein shall prevent
any credentialing organization from collecting or inquiring about any data not
available from or through the board, nor from reporting to or inquiring of the
National Practitioner Data Bank.
(2)
The board may seek an injunction
against any credentialing organization violating or attempting to violate this
act and, upon prevailing, shall be entitled to recover attorney's fees and
court costs involved in obtaining the injunction.
(g)
The board will have the authority
to hire such employees, enter into contracts with attorneys, individuals or
corporations for services, as may be necessary to bring about the purpose of
this act.
SECTION
3.
AH provisions of this act of a general and permanent
nature are amendatory to the Arkansas Code of 1987 Annotated and the Arkansas
Code Revision Commission shall incorporate the same in the
Code.
SECTION 4.
If any provision of this act or the application thereof to any person or
circumstance is held invalid, such invalidity shall not affect other provisions
or applications of the act which can be given effect without the invalid
provision or application, and to this end the provisions of this act are
declared to be severable.
SECTION
5.
All laws and parts of laws in conflict with this act
are hereby repealed.
SECTION
6.
EMERGENCY CIA USE. It is hereby found and determined
by the Eighty-second General Assembly of the State of Arkansas that hospitals,
credentialing organizations and insurance companies are in need of physician
credentialing information collected by the Arkansas State Medical Board; that
said information should be privileged and the sharing of said information
should be protected so as to enhance the credentialing process of medical
providers; that the laws protecting the credentialing process which now exist
will expire on July 1, 1999 and that passage of this act will provide for the
continued protection of the credentialing process. Therefore, an emergency is
declared to exist and this act being immediately necessary for the preservation
of the public peace, health and safety shall become effective on July 1,
1999.
/s/ Gullett
