GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2001
H	1
HOUSE BILL 1160
     

 
Short Title:	Health Ins./Uniform Provider Credentialing.	()	
Sponsors:	Representatives Alexander, C. Wilson (Primary Sponsors); and Harrington.	
Referred to:	Insurance.	
April 12, 2001

A BILL TO BE ENTITLED
AN ACT TO PROVIDE FOR UNIFORM PROVIDER CREDENTIALING BY HEALTH INSURANCE PLANS.

The General Assembly of North Carolina enacts:
SECTION 1.  Article 3 of Chapter 58 of the General Statutes is amended by adding the following new section to read:
"§ 58-3-230. Uniform provider credentialing.
(a)	An insurer that provides a health benefit plan shall maintain a process to assess and verify the qualifications of a licensed health care practitioner, or applicant for licensure as a health care practitioner, within 60 days of receipt of a completed provider application form approved by the Commissioner.
(b)	The Commissioner shall by rule adopt a uniform provider credentialing application form that will provide credentialing entities with the information necessary to adequately assess and verify the qualifications of an applicant.  No insurer that provides a health benefit plan may require an applicant to submit information that is not required by the uniform provider credentialing application form.
(c)	As used in this section the terms 'health benefit plan' and 'insurer' shall have the meaning provided under G.S. 58-3-167.
SECTION 2.  This act becomes effective October 1, 2001.