Article Provided by COPIC

Health care professionals and entities will no longer have to use the Colorado Health Care Professional Credentials Application (CHCPCA) as part of the credentialing process

During the 2022 Colorado legislative session, Senate Bill 22-226, which focused on programs to support the health care workforce, was passed. It included an amendment that repeals the Health Care Credentials Uniform Application Act. Effective May 18, 2022, health care professionals will not be required to maintain a Colorado Health Care Professional Credentials Application (CHCPCA) and health care entities will not have to use these applications as part of their credentialing process.

The goal of this amendment is to allow for more efficiency in the credentialing process by eliminating the administrative burden of having to use CHCPCA forms. It is a change that is widely supported across health care in Colorado.

What is credentialing?

The terms privileging and credentialing are often used interchangeably but are distinguished under  Colorado law. “Credentialing” means obtaining, verifying, and assessing the qualifications of a health practitioner to provide treatment, care, or services in or for a health facility.[1] “Privileging” means the authorizing by an appropriate authority, such as a governing body, of a health practitioner to provide specific treatment, care, or services at a health facility subject to limits based on factors that include license, education, training, experience, competence, health status, and specialized skill.[2]

What health care entities are required to do credentialing of health care providers?

Many health care entities must “credential” (assess and validate the qualifications of) a health care professional before:

• Allowing them to provide care at their facility or for their organization;
• Allowing them to participate in their health plan; or
• Providing them professional liability insurance.

Credentialing entities include licensed health care facilities; health care professional services corporations, LLCs or group practices; independent practice associations; insurance companies, HMOs or other entities that contract for the provision of health benefits; and professional liability insurance carriers.

What was the purpose of the Heath Care Credentials Uniform Application Act?

Because many health care providers must be credentialed through multiple credentialing entities in order to practice, the original intent of the Act (which became effective in 2004) was to make credentialing more efficient, less costly, and less duplicative by making it uniform through the use of a single application form for the collection of core credentials data.

Why is the Act being repealed?

The Colorado Health Care Professional Credentials Application was reviewed annually by the Health Care Credentials Application Review Committee, which is made up of representatives of statewide credentialing entities, other key stakeholders, and two members at large. When the Committee members met in 2019, no changes were suggested for the application at the time, but the Committee questioned the continued applicability, benefit, and use of the application. Because of the impact of COVID-19 on the health care community, the Committee did not meet again until May 2021. At that meeting, the consensus was that the requirement for a single uniform application was a deterrent for efficient credentialing.

Because there is not a centralized electronic platform to store and access the application, it has not created the benefits for the health care systems or providers as intended. Most credentialing organizations use an electronic application that must be modified from the uniform application or requires supplemental information. As a result, the state-sponsored uniform application no longer meets the Act’s goal of being more efficient, less costly, and less duplicative. The Committee members were supportive of repealing the Act since it was no longer meeting the original legislative goals and created additional burdens for credentialing entities.

Are there any concerns with how this repeal will impact health care?

The Committee members do not anticipate any negative impact on patient safety because of the independent obligations entities have to ensure that those they credential to practice within their organizations, participate in their health plans, or provide professional liability insurance for, have the appropriate qualifications and competence to provide safe patient care. These entities will continue to require the relevant information currently included in the CHCPCA form, but in a more efficient way that allows them to use an electronic application.

---

[1] C.R.S. § 25-1.5-607(1).

[2] C.R.S. § 25-1.5-607(2).