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

 

 

 

 

 

 

 

 

 

 

 

 

SUBSTITUTE FOR

 

HOUSE BILL NO. 5487

 

 

 

 

 

 

 

 

 

 

 

 

     A bill to amend 1939 PA 280, entitled

 

"The social welfare act,"

 

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

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     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.