Illinois Administrative Code
Title 77 - PUBLIC HEALTH
Part 965 - HEALTH CARE PROFESSIONAL CREDENTIALS DATA COLLECTION CODE
Subpart B - ENFORCEMENT ACTION
Section 965.300 - Single Credentialing Cycle
Current through Register Vol. 48, No. 12, March 22, 2024
a) All health care entities and health care plans shall obtain recredentialing data on a health care professional according to the single credentialing cycle beginning July 1, 2002, except:
b) Data collection for health care entities and health care plans will coincide with a single credentialing cycle that entitles health care entities and health care plans to collect recredentialing data once and not more than every 3 years, except as noted in subsection (a).
c) Data collection:
d) The single credentialing cycle reflects a 6 month "OPEN" period when health care entities and health care plans cannot collect data from a health care professional, except as noted in subsection (a). This period coincides with the Illinois Department of Professional Regulation's licensing schedule of physicians.
e) The single credentialing cycle is established as follows:
July |
OPEN |
August |
OPEN |
September |
OPEN |
October |
OPEN |
November |
OPEN |
December |
OPEN |
January |
Notification (0's) |
February |
Collection of data |
March |
Collection of data |
April |
Notification (1's) |
May |
Collection of data |
June |
Collection of data |
July |
Notification (2's) |
August |
Collection of data |
September |
Collection of data |
October |
Notification (3's) |
November |
Collection of data |
December |
Collection of data |
January |
Notification (4's) |
February |
Collection of data |
March |
Collection of data |
April |
Notification (5's) |
May |
Collection of data |
June |
Collection of data |
July |
Notification (6's) |
August |
Collection of data |
September |
Collection of data |
October |
Notification (7's) |
November |
Collection of data |
December |
Collection of data |
January |
Notification (8's) |
February |
Collection of data |
March |
Collection of data |
April |
Notification (9's) |
May |
Collection of data |
June |
Collection of data |
f) Once recredentialing is begun in accordance with the single credentialing cycle, a health care entity or health care plan may continue to request data from a health care professional outside of the published single credentialing cycle if it is not submitted by the deadline date published in the schedule.
g) Nothing in this Section shall be construed to preclude, or otherwise exempt, a health care plan from monitoring, on an ongoing basis, in between recredentialing cycles, information on sanctions, limitations on licensure, and complaints against health care professionals consistent with guidelines issued by any entity that provides private accreditation to health care plans, or from meeting any quality assurance requirement of the entity related to credentialing for the purpose of accreditation or otherwise.
h) The requirements of this Section apply only to health care plans and health care entities as defined in the Act [410 ILCS 517/5 ].