Bill Text: MI HB5487 | 2017-2018 | 99th Legislature | Engrossed

Bill Title: Human services; medical services; universal Medicaid credentialing process; create. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 111m.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Engrossed - Dead) 2018-04-10 - Referred To Committee On Health Policy [HB5487 Detail]

Download: Michigan-2017-HB5487-Engrossed.html

HB-5487, As Passed House, March 22, 2018




























     A bill to amend 1939 PA 280, entitled


"The social welfare act,"


(MCL 400.1 to 400.119b) by adding section 111m.




     Sec. 111m. (1) The department shall work with contracted


health plans to do all of the following:


     (a) Establish and revise, as necessary, a uniform


credentialing process for providers of medical assistance required


in this section. In complying with this subsection, the department


shall consult with medical services providers that are required to


accept credentialing under this section.


     (b) Ensure that the uniform credentialing process establishes


a streamlined uniform credentialing requirement for an individual


who provides medical services through a contracted health plan.

House Bill No. 5487 as amended March 21, 2018

     (c) By 6 months after the effective date of the amendatory act


that added this section and annually after that date, submit a


report to the legislature that describes its activities under this


section, including establishment of and any revisions to the


uniform credentialing process.


     (2) A managed care provider that provides, either directly or


through a contract, medical services to medical assistance


recipients of this state must comply with the uniform credentialing


process. On and after the date the uniform credentialing process is


certified by the director of the department as being in full force


and effect, the department must ensure that all of the forms and


processes it uses that relate to providing medical services comply


with the uniform credentialing process. Until 3 years after the


effective date of the amendatory act that added this section, this


subsection does not apply to a managed care provider contracting


with a health plan in a region that is served by fewer than 2


health plans.


[(3) Primary or secondary credential verification remains the


responsibility of each individual health plan. This section does not

 prohibit a managed care plan from approving or denying a medical

services provider's participation in the managed care plan, or from collecting additional information from a medical services provider necessary to meet federal or state law, a requirement of a managed

care contract with the department, or plan-specific metrics.]


     (4) As used in this section, "uniform credentialing process"


means the uniform medical service provider credentialing process


established, maintained, and revised as required in subsection


(1)(a) that meets state and federally recognized standards.


     Enacting section 1. This amendatory act takes effect 90 days


after the date it is enacted into law.