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2020 SESSION

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20101925D
SENATE BILL NO. 365 Offered January 8, 2020 Prefiled January 6, 2020 A BILL to direct the State Board of Health to promulgate regulations regarding the credentialing process for health care providers; health carriers and hospitals. ---------- Patron-- Dunnavant ---------- Referred to Committee on Education and Health ----------

Be it enacted by the General Assembly of Virginia:

1. § 1. As used in this act:

"Covered person" means a policyholder, subscriber, enrollee, participant, or other individual covered by a health benefit plan.

"Health benefit plan" means a policy, contract, certificate, or agreement offered by a health carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services.

"Health carrier" means an entity subject to the insurance laws and regulations of the Commonwealth and subject to the jurisdiction of the State Corporation Commission that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services or mental health services, including an insurer licensed to sell accident and sickness insurance, a health maintenance organization, a health services plan, or any other entity providing a plan of health insurance, health benefits, health care services, or mental health services.

§ 2. The State Board of Health shall promulgate regulations requiring a health carrier to establish reasonable protocols and procedures that deem a provider credentialed who has been approved for credentialing by a licensed hospital within 14 days of such approval if such licensed hospital has a contract with the health carrier to provide health care services to a covered person under a health benefit plan offered by the health carrier as a member of the health benefit plan's network.