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SPONSOR: |
Marquardt |
DATE TYPED: |
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HB |
968/aHBIC |
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SHORT TITLE: |
Health Care Provider Licensing Task Force |
SB |
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APPROPRIATION
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Additional Impact |
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FY04 |
FY03 |
FY04 |
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See Narrative |
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(Parenthesis
( ) Indicate Expenditure Decreases)
Responses
Received From
Department
of Health (DOH)
Health
Policy Commission (HPC)
SUMMARY
The House Business and Industry Committee amends the bill by inserting “Temporary Provision” for the
heading in Section 1. The change in the
heading is consistent with the language contained in the section.
Synopsis
of Original Bill
House
Bill 968 creates a health care providers licensing and credentialing task force
under the New Mexico Health Policy Commission and would provide for the duties
and the membership of the task force with a goal to study and make
recommendations to consolidate and simplify health care licensure
processes. HB 968 also would establish
an information technology project manager and would authorize the use of funds
to pay for information technology support.
q
Section 1 includes findings of the House
Joint Memorial 61 Subcommittee to study licensing of professionals and
recommends that a system be produced that is satisfactory to all organizations
with a primary goal of ensuring the health and safety of
q
Section 2 has a duty for the task force
to study and make recommendations to the Superintendent of Insurance on health
care provider credentialing. It would
assign participation on the task force to the Health Policy Commission and the
Department of Health (DOH), along with a number of other licensing agencies and
boards and associations. Section 2 also
states that the Health Policy Commission, Board of Nursing and Board of Medical
Examiners together would fund an information technology project manager to
develop and implement a web site portal for licensure and a central database
for credentialing of health care providers.
q
Section 3 would require the
Superintendent of Insurance to adopt rules to ensure third-party payer
credentialing requirements.
q
Section 4 would require the Human
Services Department to negotiate with Medicaid contractors to coordinate
credentialing of individual providers.
q
Section 5 would amend Section 61-3-27-1,
NMSA 1978, to allow the Board of Nursing to expend funds to support the
information technology project.
q
Section 6 would amend Section 61-6-31.1
NMSA 1978, to allow the Board of Medical Examiners to expend funds for the
information technology project.
Significant
Issues
A House Joint Memorial 61 Subcommittee met in 2002 to study
problems of health care provider credentialing. The goal was to look at ways to
reduce duplication and unnecessary delays in the licensing and credentialing
process. The HJM 61 Committee recommended the creation of a task force to
continue the work that has been accomplished. The Health Policy Commission was
responsible for staffing the HJM 61 Committee.
HB 968 would create the recommended task force.
Credentialing
of physicians and other health care providers can be delayed for extremely long
periods. There are many different
licensing boards and agencies within the State.
The goal of the task force would be to bring everyone together to find
ways to eliminate duplication and delays.
Providing a system of licensure and credentialing of health care
providers that allows for a one-time application effort by the provider across
professions and for multiple systems of care would increase efficiency for both
the provider and the licensing agencies.
By improving the efficiency of the system, it is projected that there
will be a cost and time savings to patients and third-party payers.
FISCAL IMPLICATIONS
Fiscal
implications to the HPC are relatively limited – existing staff resources can
be re-prioritized to carry out this project.
The
HPC is to work with the Board of Medical Examiners and the Board of Nursing to
hire an information technology project manager to design, implement and
maintain the web portal and database for credentialing of health care
providers. The Board of Medical
Examiners and the Board of Nursing shall authorize expenditures from their
respective cash balances to pay for the manager and the development,
implementation and maintenance of the web site portal.
The Board of Nursing has requested $25,000 out of
the cash balance to work with the HPC and the Board of Medical Examiners to
hire an information technology project manager.
ADMINISTRATIVE IMPLICATIONS
The
DOH would need to be represented on the task force for each of the different
licensing functions including the Injury Prevention/EMS Bureau, Family Health
Bureau, Office of Rural Health, and others.
This could be managed within current resources.
There are significant performance implications for the HPC. To effectively respond to HJM61 last year, the HPC assigned three staff to the project, one lead and two assisting. In addition, the Director and Deputy Director were involved with the full HJM61 Task Force meetings and final reports to the LHHS.
The
Board of Nursing participated on HJM61 task force last year. A staff member or board member would be able
to participate on the task force again this year. Staff time would also be required to oversee
the manager, give input for an evaluation of current system and make recommendations
for the development of the portal. Staff
time would also be required to monitor the contract.
RELATIONSHIP
HB
968 relates to SB 269, which would prohibit professional licensing boards from
issuing temporary or emergency licenses to practice prior to issuance of a
regular license.
TECHNICAL ISSUES
HSD concern with HB
968 is that it requires the task force to make recommendations to the Superintendent
of Insurance on health care provider credentialing issues and give the
Superintendent the authority to adopt rules concerning these critical
issues. It is highly inappropriate and
possibly a conflict of interest for the Superintendent of Insurance to be
charged with these tasks and granted this authority. Professional health care licensing should be
the province of the relevant medical boards, not of a government agency that
regulates a profit-making industry. The subject matter over which the
Superintendent of Insurance has supervisory authority concerns the licensure of
insurance agents, insurance agencies and insurance companies, not health care
practitioners.
HB 968 would require
HSD to "negotiate with Medicaid contractors to ensure that the contractors'
credentialing requirements are coordinated with other credentialing processes
required of individual providers." This provision would require HSD to
engage in a level of oversight and micro-management of its providers that would
be intrusive to the providers' business and would not be cost effective for the
Department.
OTHER SUBSTANTIVE ISSUES
The current health professional workforce shortage is
reaching crisis level. According to the
New Mexico Health Policy Commission’s Quick Facts 2001 Report, the 4%
population growth in the state from 1999 to 2000 did not impact
Safety
net providers (e.g. primary care centers, rural hospitals, community mental
health centers, etc.) rely on temporary licensure to assure access to care and
maintenance of clinical services. The DOH contracts with more than 75
community-based primary care centers in under-served areas. An efficient
coordinated system of licensure and credentialing would positively impact
efforts to recruit and retain health professionals impacting health disparities
of vulnerable recruitment populations.
HB 968 would support the DOH in helping to meet the needs of the State's
health care safety net.
For the State, as for hospitals and MCOs, the
duplication and redundancy is costly and inefficient. For the health care professional, the
paperwork alone can be overwhelming, and the waiting time can be economically
difficult. The burden created by these
processes can be so great as to be a disincentive for health care providers to
locate and practice in
In response to HJM 61, the HPC conducted a study
of licensing and credentialing in the state that included a review of what
other states are doing on this front, and what some state agencies and
organizations have already done to try to streamline their own processes.
The
HPC has an additional reason for supporting the web portal and the
database. The HPC is statutorily
mandated to collect and assess information about health professionals in
AMENDMENTS
(1)
Eliminate the requirements that
the task force make recommendations to the Superintendent of Insurance and that
the Superintendent adopt rules concerning those recommendations.
(2)
Eliminate the requirement that
HSD negotiate with Medicaid contractors to ensure that the contractors'
credentialing requirements are coordinated with other credentialing processes required
of individual providers.
BD/njw:yr