Sec. 9. (a) The office shall implement a centralized credentials verification organization and credentialing process that:

(1) uses a common application, as determined by provider type;

(2) issues a single credentialing decision applicable to all Medicaid programs, except as determined by the office;

(3) recredentials and revalidates provider information not less than once every three (3) years;

(4) requires attestation of enrollment and credentialing information every six (6) months; and

(5) is certificated or accredited by the National Committee for Quality Assurance or its successor organization.

(b) A managed care organization or contractor of the office may not require additional credentialing requirements in order to participate in a managed care organization's network. However, a contractor may collect additional information from the provider in order to complete a contract or provider agreement.

(c) A managed care organization or contractor of the office is not required to contract with a provider.

(d) A managed care organization or contractor of the office shall:

(1) send representatives to meetings and participate in the credentialing process as determined by the office; and

(2) not require additional credentialing information from a provider if a non-network credentialed provider is used.

(e) Except when a provider is no longer enrolled with the office, a credential acquired under this chapter is valid until recredentialing is required.

(f) An adverse action under this section is subject to IC 4-21.5.

(g) The office may adopt rules under IC 4-22-2 to implement this section.

(h) The office may adopt emergency rules to implement this section. However, an emergency rule adopted under this section expires the earlier of:

(1) one (1) year after the rule was accepted for filing under IC 4-22-2-37.1(e); or

(2) June 30, 2019.

This subsection expires July 1, 2019.

(i) The office shall report the timeliness of determinations made under this section to the legislative council in an electronic format under IC 5-14-6 not later than December 31, 2018. This subsection expires January 1, 2019.

As added by P.L.195-2018, SEC.5.