HF 618 (LSB 2061YH (2) 88)

HOUSE FILE 618

BY  FRY

A BILL FOR

An Act relating to the uniform credentialing and recredentialing of providers under the Medicaid program.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  DEPARTMENT OF HUMAN SERVICES —— SINGLE CREDENTIALING VERIFICATION ORGANIZATION —— USE OF UNIFORM AUTHORIZATION CRITERIA —— MEDICAID PROGRAM.  The department of human services shall develop uniform authorization criteria for, and shall utilize a request for proposals process to select a single credentialing verification organization to be utilized in, credentialing and recredentialing providers for the Medicaid managed care and fee-for-service payment and delivery systems. The department shall contractually require all Medicaid managed care organizations to utilize the single credentialing verification organization selected and to apply the uniform authorization criteria developed by the department.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill requires the department of human services to develop uniform authorization criteria for, and to utilize a request for proposals process to select a single credentialing verification organization to be utilized in, credentialing and recredentialing providers for the Medicaid managed care and fee-for-service payment and delivery systems. The department shall contractually require all Medicaid managed care organizations to utilize the single credentialing verification organization selected and to apply the uniform authorization criteria developed by the department.