500.3528 Health maintenance organization; credentialing verification; accreditation by nationally recognized accredited body.
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500.3528 Health maintenance organization; credentialing verification; accreditation by nationally recognized accredited body.
Sec. 3528.
(1)A health maintenance organization shall establish written policies and procedures for credentialing verification of all health professionals with whom the health maintenance organization contracts. A health maintenance organization shall apply these standards consistently. This act does not require a health maintenance organization to select a provider as an affiliated provider solely because the provider meets the health maintenance organization's credentialing verification standards. This act does not prevent a health maintenance organization from using separate or additional criteria in selecting the health professionals with whom it contracts.
(2)A health maintenance organization is considered to meet the requirements of this section if the health maintenance organization is accredited by a nationally recognized accredited body approved by the director. As used in this subsection, "nationally recognized accredited body" includes the National Committee for Quality Assurance.
History: Add. 2000, Act 252 , Imd. Eff. June 29, 2000 ;-- Am. 2002, Act 621 , Imd. Eff. Dec. 23, 2002 ;-- Am. 2016, Act 276 , Imd. Eff. July 1, 2016
Popular Name: Act 218
Popular Name: HMO