* This bulletin was repealed by 08-05

To:           All Licensed Health Maintenance Organizations

From:      Jay Angoff, Director

Re:          Standardized Credentialing Form Supplement

Date:       July 2, 1998

Several licensed health maintenance organizations (HMO's) have brought to the director's attention that 20 CSR 400-7.180, Exhibit A (the standardized credentialing form), does not include a question which would gather information which the National Committee for Quality Assurance (NCQA) requires in order for an HMO to gain NCQA accreditations.  In order to bring Missouri's standardized credentialing form into accord with NCQA's credentialing criteria pursuant to section 354.442.1(15), RSMo (Cum. Supp. 1997), and 20 CSR 400-7.180, the department approved the following as a supplement to the standardized credentialing form:

Provide a statement regarding the reasons for any inability to perform the essential functions, with or without reasonable accommodations, for the practice in which you are seeking to become a participating provider.

All licensed health maintenance organizations may require applicants for their provider network to answer this question as a supplement to completion of the standardized credentialing form.

The director is also interested in receiving any other comments or suggestions which the managed care industry regards as improvement to the standardized credentialing form.   Please address such comments or suggestions to Tom Bixby, Division of Consumer Affairs.

In the near future, the director plans to amend 20 CSR 400-7.180, Exhibit A, to incorporate the supplement.