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Oregon Bill Promises One-Stop Credentialing

June 27, 2013
Written by: , Filed in: Practice Management
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Oregon State Senator Alan Bates, DO, told his colleagues that for his medical practice he has to be credentialed each year by up to 40 different insurance companies plus two hospitals.

That’s why the Democrat from Medford, in southwest Oregon, co-sponsored Senate Bill 604, which would create a single credentialing process for all insurers, hospitals, and coordinated care organizations to share. The bill would also set up a uniform, mandatory electronic credentialing database.

The Oregon Legislature passed the bill earlier this week. It awaits the signature of Governor John Kitzhaber, MD, a former emergency department physician.

Backers of the bill say it could cut $150 million in annual administrative costs for Oregon health care providers. According to The Lund Report, an online news service that covers health care in Oregon, Dr. Bates said it would have a major positive impact:

This is a huge savings in the providers’ time. Each of them ask for something different, but essentially the same information.

Everybody seems to like the bill. It passed both houses of the Legislature unanimously. The Oregon Medical Association, the Oregon Nurses Association, the Oregon Association of Hospitals and Health Systems, and leading insurance companies, including the state’s largest in terms of enrollment, Regence BlueCross BlueShield of Oregon, all backed it.

The Oregon Health Authority, the state’s main health care agency, will set up the program and database, with a deadline of January 1, 2016. User fees will fund the system.

Oregon’s Legislature has passed two similar bills this session. House Bill 2020 directs coordinated care organizations to adopt a single credentialing process for mental health care providers. It requires that if a provider’s credentials are accepted at one CCO, other CCOs must accept them as well.

And Senate Bill 569 sets up a universal, statewide credentialing process for telemedicine providers. Such providers would be credentialed only once through the state rather than individually by each hospital that uses their services.

Senator Elizabeth Steiner Hayward, MD, a Democrat from Beaverton, a family physician, and a co-sponsor of the telemedicine bill, said, “A 20th-century regulatory system still hampers our ability to offer 21st-century care where it’s most urgently needed.”

Related CME seminar (up to 29.75 AMA PRA Category 1 credits™): UCSF Radiology Review: CLINICAL HIGHLIGHTS

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