☰ Revisor of Missouri

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS

Chapter 376

< > Effective - 01 Jan 2014, 2 histories, see footnote (history) bottom

  376.1578.  Credentialing procedure, health carrier duties — violations, mechanism for reporting. — 1.  Within two working days after receipt of a faxed or mailed completed application, the health carrier shall send a notice of receipt to the practitioner.  A health carrier shall provide access to a provider web portal that allows the practitioner to receive notice of the status of an electronically submitted application.

  2.  A health carrier shall assess a health care practitioner's credentialing information and make a decision as to whether to approve or deny the practitioner's credentialing application within sixty business days of the date of receipt of the completed application.  The sixty-day deadline established in this section shall not apply if the application or subsequent verification of information indicates that the practitioner has:

  (1)  A history of behavioral disorders or other impairments affecting the practitioner's ability to practice, including but not limited to substance abuse;

  (2)  Licensure disciplinary actions against the practitioner's license to practice imposed by any state or territory or foreign jurisdiction;

  (3)  Had the practitioner's hospital admitting or surgical privileges or other organizational credentials or authority to practice revoked, restricted, or suspended based on the practitioner's clinical performance; or

  (4)  A judgment or judicial award against the practitioner arising from a medical malpractice liability lawsuit.

  3.  The department of commerce and insurance shall establish a mechanism for reporting alleged violations of this section to the department.

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(L. 2013 S.B. 262)

Effective 1-01-14


---- end of effective  01 Jan 2014 ----

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376.1578 8/28/2020
376.1578 1/1/2014 8/28/2020

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