Chapter 494 Oregon Laws 1999

Session Law

AN ACT

HB 2144

Relating to credentialing of physicians.

Be It Enacted by the People of the State of Oregon:

SECTION 1. (1) The Advisory Committee on Physician Credentialing Information is established within the Office for Oregon Health Plan Policy and Research. The committee consists of nine members appointed by the Administrator of the Office for Oregon Health Plan Policy and Research as follows:

(a) Three members who are physicians licensed by the Board of Medical Examiners for the State of Oregon or representatives of physician organizations doing business within the State of Oregon;

(b) Three representatives of hospitals licensed by the Health Division; and

(c) Three representatives of health care service contractors that have been issued a certificate of authority to transact health insurance in this state by the Department of Consumer and Business Services.

(2) All members appointed pursuant to subsection (1) of this section shall be knowledgeable about national standards relating to physician credentialing.

(3) The term of appointment for each member of the committee is three years. If, during a member's term of appointment, the member no longer qualifies to serve as designated by the criteria of subsection (1) of this section, the member must resign. If there is a vacancy for any cause, the administrator shall make an appointment to become immediately effective for the unexpired term.

(4) Members of the committee are not entitled to compensation or reimbursement of expenses.

SECTION 2. (1) Notwithstanding the term of appointment specified in section 1 of this 1999 Act, of the members first appointed to the Advisory Committee on Physician Credentialing Information:

(a) One member from each category designated by the criteria of section 1 (1) of this 1999 Act shall serve for a term ending one year from the date of appointment.

(b) One member from each category designated by the criteria of section 1 (1) of this 1999 Act shall serve for a term ending two years from the date of appointment.

(c) One member from each category designated by the criteria of section 1 (1) of this 1999 Act shall serve for a term ending three years from the date of appointment.

(2) At the first meeting of the committee, the committee shall determine by lot the initial term of appointment for each member.

SECTION 3. (1) The Advisory Committee on Physician Credentialing Information shall develop and submit recommendations to the Administrator of the Office for Oregon Health Plan Policy and Research for the collection of uniform information necessary for hospitals and health plans to credential physicians seeking membership on a hospital medical staff or designation as a participating provider for a health plan. The recommendations must specify:

(a) The content and format of a credentialing application form; and

(b) The content and format of a recredentialing application form.

(2) The committee shall meet at least once every calendar year to review the uniform credentialing information and to assure the administrator that the information complies with credentialing standards developed by national accreditation organizations and applicable regulations of the federal government.

(3) The Office for Oregon Health Plan Policy and Research shall provide the support staff necessary for the committee to accomplish its duties.

SECTION 4. (1) Within 30 days of receiving the recommendations of the Advisory Committee on Physician Credentialing Information, the Administrator of the Office for Oregon Health Plan Policy and Research shall forward the recommendations to the Director of the Department of Consumer and Business Services and to the Assistant Director for Health. The administrator shall request that the department and the Health Division adopt rules to carry out the efficient implementation and enforcement of the recommendations of the committee.

(2) The department and the division shall:

(a) Adopt administrative rules in a timely manner, as required by the Administrative Procedures Act, for the purpose of effectuating the provisions of sections 1 to 4 of this 1999 Act; and

(b) Consult with each other and with the administrator to ensure that the rules adopted by the department and the division are identical and are consistent with the recommendations developed pursuant to section 3 of this 1999 Act for affected hospitals and health care service contractors.

(3) The uniform credentialing information required pursuant to the administrative rules of the department and the division represent the minimum uniform credentialing information required by the affected hospitals and health care service contractors. Nothing in sections 1 to 4 of this 1999 Act shall be interpreted to prevent an affected hospital or health care service contractor from requesting additional credentialing information from a licensed physician for the purpose of completing physician credentialing procedures used by the affected hospital or health care service contractor.

Approved by the Governor July 6, 1999

Filed in the office of Secretary of State July 6, 1999

Effective date October 23, 1999

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