GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 2001

 

 

SESSION LAW 2001-172

HOUSE BILL 1160

 

 

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 and that credentials providers for its networks 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 credentialing application form approved by the Commissioner.

(b)       The Commissioner shall by rule adopt a uniform provider credentialing application form that will provide health benefit plans with the information necessary to adequately assess and verify the qualifications of an applicant. The Commissioner may update the uniform provider credentialing application form, as necessary. 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.

In the General Assembly read three times and ratified this the 30th day of May, 2001.

 

 

                                                                    s/ Beverly E. Perdue

                                                                         President of the Senate

 

 

                                                                    s/ James B. Black

                                                                         Speaker of the House of Representatives

 

 

                                                                    s/ Michael F. Easley

                                                                         Governor

 

 

Approved 9:01 a.m. this 7th day of June, 2001