Senate Bill No. 244–Committee on Human
Resources and Facilities

 

February 26, 2001

____________

 

Referred to Committee on Commerce and Labor

 

SUMMARY—Requires certain providers of health care to submit their credentials to verification organization. (BDR 54‑974)

 

FISCAL NOTE:            Effect on Local Government: No.

                                    Effect on the State: No.

 

~

 

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

 

AN ACT relating to health care; requiring certain providers of health care to submit their credentials to a verification organization; requiring a verification organization to submit those credentials to a health care entity or a licensing board under certain circumstances; prohibiting a health care entity or licensing board from obtaining or attempting to obtain the credentials of a provider of health care under certain circumstances; requiring a verification organization to register with the division of insurance of the department of business and industry before conducting business in this state; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

1-1    Section 1. Chapter 629 of NRS is hereby amended by adding thereto

1-2  the provisions set forth as sections 2 to 12, inclusive, of this act.

1-3    Sec. 2.  “Credentials” means any information concerning the

1-4  education, licensing, certification or employment of a provider of health

1-5  care, including:

1-6    1.  His name, address and social security number;

1-7    2.  His professional education and training, including any internship,

1-8  residency or fellowship completed by him relating to the profession for

1-9  which he is licensed, registered or certified;

1-10    3.  Any license or certificate issued to him to practice as a provider of

1-11  health care, including any certificate issued for a specialized area of

1-12  practice;

1-13    4.  Any hospital or other institution for which he has provided

1-14  medical services, including the name and address of each hospital or

1-15  institution, his position on the staff of the hospital or institution, and the

1-16  period during which he provided the medical services for the hospital or

1-17  institution;

2-1    5.  Evidence of any professional liability insurance maintained by

2-2  him;

2-3    6.  A record of any legal or disciplinary action taken against him

2-4  relating to the profession for which he is licensed, registered or certified;

2-5    7.  Any registration number issued to him by the Drug Enforcement

2-6  Administration of the United States Department of Justice or its

2-7  successor agency;

2-8    8.  Any certificate issued to him by the Educational Commission for

2-9  Foreign Medical Graduates; and

2-10    9.  Any other information required by the division.

2-11    Sec. 3.  “Division” means the division of insurance of the

2-12  department of business and industry.

2-13    Sec. 4.  “Health care entity” means:

2-14    1.  Any health care facility or other health care organization licensed

2-15  or certified to provide health care services in this state, including, without

2-16  limitation, a health maintenance organization as defined in NRS

2-17  695C.030;

2-18    2.  Any insurer as defined in NRS 679B.540; or

2-19    3.  Any accredited medical school in this state.

2-20    Sec. 5.  “Licensing board” means any board that is authorized to

2-21  adopt standards for the issuance or renewal of a license or certificate for

2-22  a provider of health care.

2-23    Sec. 6.  “Verification organization” means any organization that:

2-24    1.  Is certified or accredited by the National Committee for Quality

2-25  Assurance, the Joint Commission on Accreditation of Healthcare

2-26  Organizations or any other nationally recognized organization approved

2-27  by the department; and

2-28    2.  Verifies the credentials of a provider of health care.

2-29    Sec. 7.  Each provider of health care shall:

2-30    1.  Within 45 days after he is issued a license or certificate to practice

2-31  as a provider of health care, submit his credentials to a verification

2-32  organization that is registered with the division;

2-33    2.  Notify the verification organization within 45 days of any

2-34  correction, revision or modification to his credentials submitted pursuant

2-35  to subsection 1; and

2-36    3.  Within 10 days after submitting his credentials to a verification

2-37  organization, provide a written notice to the division setting forth the

2-38  name and address of the verification organization.

2-39    Sec. 8.  1.  Each verification organization shall:

2-40    (a) Prepare and maintain a record of the credentials of each provider

2-41  of health care and any correction, revision or modification to the

2-42  credentials submitted pursuant to section 7 of this act;

2-43    (b) Prepare and make available to each provider of health care a form

2-44  for use by the provider of health care for submitting the information

2-45  required pursuant to section 7 of this act; and

2-46    (c) Within 30 days after receiving a request for the credentials of a

2-47  provider of health care submitted by a health care entity or a licensing

2-48  board, provide the credentials to the health care entity or licensing board.

3-1    2.  A verification organization shall not charge or collect a fee from a

3-2  provider of health care for submitting to the verification organization his

3-3  credentials or any correction, revision or modification of those

3-4  credentials.

3-5    Sec. 9.  1.  Before obtaining or attempting to obtain the credentials

3-6  of a provider of health care, a health care entity or licensing board shall

3-7  determine whether the credentials are available from a verification

3-8  organization. If it determines that the credentials are available from a

3-9  verification organization, the health care entity or licensing board shall

3-10  not obtain or attempt to obtain the credentials from the provider of health

3-11  care without his consent.

3-12    2.  The provisions of this section do not prohibit a health care entity

3-13  or licensing board from obtaining the credentials of a provider of health

3-14  care if those credentials are not included in the record of the provider of

3-15  health care maintained by a verification organization pursuant to section

3-16  8 of this act.

3-17    Sec. 10.  1.  A verification organization shall not conduct business

3-18  in this state unless it is:

3-19    (a) Accredited or certified as a verification organization by a national

3-20  accrediting organization; and

3-21    (b) Registered with the division.

3-22    2.  A verification organization may apply to the department for a

3-23  certificate of registration. The application must be submitted on a form

3-24  provided by the division and include any information concerning the

3-25  verification organization required by the division.

3-26    3.  The division shall, within 30 days after receiving an application

3-27  for registration, approve or deny the application. If the division denies

3-28  the application, the division shall notify the verification organization in

3-29  writing of that fact within 10 days after denying the application. If the

3-30  division approves the application, the division shall, upon the payment of

3-31  any fee prescribed by the division, issue a certificate of registration to the

3-32  verification organization. The certificate of registration is valid for 2

3-33  years and may be renewed.

3-34    4.  The division may prescribe a fee for the issuance or renewal of a

3-35  certificate of registration. If the division prescribes such a fee, the fee

3-36  must not exceed the cost of issuing or renewing the certificate.

3-37    5.  The division may revoke, suspend or refuse to renew a certificate

3-38  of registration issued to a verification organization if the verification

3-39  organization:

3-40    (a) Fails to maintain its accreditation or certification with a national

3-41  accrediting organization;

3-42    (b) Fails to provide to the division the credentials of a provider of

3-43  health care or any correction, revision or modification to those

3-44  credentials upon request by the division; or

3-45    (c) Fails to provide to a health care entity or a licensing board the

3-46  credentials of a provider of health care within the period specified in

3-47  paragraph (c) of subsection 1 of section 8 of this act.

3-48    6.  As used in this section, “national accrediting organization” means

3-49  the National Committee for Quality Assurance, the Joint Commission on

4-1  Accreditation of Healthcare Organizations or any other nationally

4-2  recognized organization that certifies or accredits verification

4-3  organizations.

4-4    Sec. 11.  Each verification organization shall, during any period in

4-5  which it conducts business in this state, maintain a policy of liability

4-6  insurance in an amount determined by the division.

4-7    Sec. 12.  The division shall adopt regulations to carry out the

4-8  provisions of sections 2 to 12, inclusive, of this act. The regulations must

4-9  prescribe, without limitation:

4-10    1.  The manner in which a verification organization must notify a

4-11  provider of health care if the verification organization ceases to conduct

4-12  business in this state or if the certificate of registration of the verification

4-13  organization is revoked, suspended or not renewed;

4-14    2.  The manner in which a provider of health care who has submitted

4-15  his credentials to such a verification organization must submit his

4-16  credentials to another verification organization or the division; and

4-17    3.  The fee that a verification organization may charge and collect

4-18  from a health care entity or a licensing board for providing the

4-19  credentials of a provider of health care to the health care entity or

4-20  licensing board.

4-21    Sec. 13.  NRS 629.011 is hereby amended to read as follows:

4-22    629.011  As used in this chapter, unless the context otherwise requires,

4-23  the words and terms defined in NRS 629.021 and 629.031 and sections 2

4-24  to 6, inclusive, of this act have the meanings ascribed to them in those

4-25  sections.

4-26    Sec. 14.  NRS 629.031 is hereby amended to read as follows:

4-27    629.031  1.  “Provider of health care” means a physician licensed

4-28  pursuant to chapter 630, 630A or 633 of NRS, dentist, licensed nurse,

4-29  dispensing optician, optometrist, practitioner of respiratory care, registered

4-30  physical therapist, podiatric physician, licensed psychologist, licensed

4-31  marriage and family therapist, chiropractor, doctor of Oriental medicine in

4-32  any form, medical laboratory director or technician, pharmacist or a

4-33  licensed hospital as the employer of any such person.

4-34    2.  For the purposes of NRS 629.051, 629.061 and 629.065, the term

4-35  includes a facility that maintains the health care records of patients.

4-36    3.  For the purposes of sections 2 to 12, inclusive, of this act, the term

4-37  does not include a licensed hospital specified in subsection 1.

4-38    Sec. 15.  Notwithstanding the provisions of section 7 of this act, each

4-39  holder of:

4-40    1.  A license to practice as a physician issued pursuant to chapter 630,

4-41  630A or 633 of NRS;

4-42    2.  A license to practice as a dentist issued pursuant to chapter 631 of

4-43  NRS;

4-44    3.  A license to engage in the practice of nursing issued pursuant to

4-45  chapter 632 of NRS;

4-46    4.  A license to practice as a chiropractor issued pursuant to chapter

4-47  634 of NRS;

4-48    5.  A license to engage in the practice of Oriental medicine issued

4-49  pursuant to chapter 634A of NRS;

5-1    6.  A license to practice as a podiatric physician issued pursuant to

5-2  chapter 635 of NRS;

5-3    7.  A license to practice as an optometrist issued pursuant to chapter

5-4  636 of NRS;

5-5    8.  A license to practice as a dispensing optician issued pursuant to

5-6  chapter 637 of NRS;

5-7    9.  A certificate of registration as a pharmacist issued pursuant to

5-8  chapter 639 of NRS;

5-9    10.  A license as a registered physical therapist issued pursuant to

5-10  chapter 640 of NRS;

5-11    11.  A certificate as a practitioner of respiratory care issued pursuant to

5-12  chapter 640B of NRS;

5-13    12.  A license to practice as a psychologist issued pursuant to chapter

5-14  641 of NRS;

5-15    13.  A license to practice as a marriage and family therapist issued

5-16  pursuant to chapter 641A of NRS;

5-17    14.  A license to practice as a laboratory director issued pursuant to

5-18  chapter 652 of NRS; or

5-19    15.  A certificate to practice as a medical laboratory technician issued

5-20  pursuant to chapter 652 of NRS,

5-21  shall, on or before July 1, 2002, submit the information required pursuant

5-22  to section 7 of this act to a verification organization that is registered with

5-23  the division of insurance of the department of business and industry in

5-24  accordance with section 10 of this act, and provide to the division a written

5-25  notice setting forth the name and address of the verification organization.

5-26    Sec. 16.  This act becomes effective upon passage and approval for the

5-27  purpose of adopting regulations by the division of insurance of the

5-28  department of business and industry to carry out the provisions of sections

5-29  2 to 12, inclusive, of this act and on July 1, 2002, for all other purposes.

 

5-30  H