906 KAR 1:150. Uniform evaluation
and reevaluation of a health care professional.
RELATES TO: KRS
AUTHORITY: KRS 216B.040(3)(a), 216B.042(1)
FUNCTION, AND CONFORMITY: KRS 216B.040(3)(a) authorizes and KRS 216B.042(1) requires
the Cabinet for Health and Family Services to establish licensure standards and
procedures to ensure safe, adequate, and efficient health facilities and health
services. KRS 304.17A-545(5) requires the executive director of the Office of
Insurance to establish a uniform application form and guidelines for evaluating
and reevaluating health care providers. This administrative regulation
establishes the requirement for uniform credentialing of a health care
professional who provides services in a health care facility or service and is
implemented in accordance with KRS 304.17A-545(5) and 806 KAR 17:480.
Definitions. (1) "Cabinet" means the Cabinet for Health and Family
"Credentialing" means a process to be completed before a health care
professional is granted privileges at a health facility or health service.
(a) A process for
collecting and verifying the professional qualifications of a health care
(b) An assessment
of whether a health care professional meets specified criteria for professional
competence and conduct.
care professional" means a:
(a) Physician or
osteopath who is required to be licensed by KRS 311.560;
(b) Podiatrist who
is required to be licensed by KRS 311.400;
who is required to be licensed by KRS 312.018;
(d) Dentist who is
required to be licensed by KRS 313.020;
who is required to be licensed by KRS 320.220;
assistant who is required to be licensed by KRS 311.844;
registered nurse practitioner who is required to be licensed by KRS 314.042;
(h) Nurse who is
required to be licensed by KRS 314.041;
care practitioner who is required to be licensed by KRS 314A.110;
who is required to be licensed by KRS 319.005;
therapist who is required to be licensed by KRS 319A.080;
therapist who is required to be licensed by KRS 327.020;
language pathologist or audiologist who is required to be licensed by KRS
(n) Social worker
who is required to be licensed by KRS 335.030;
counselor who is required to be licensed by KRS 335.505; or
individuals who are not licensed under the Kentucky Revised Statutes who
provide health care services under the direction and supervision of a licensed
care provider" means a health facility or health service required to be
licensed pursuant to KRS 216B.105.
facility" is defined by KRS 216B.015(12).
service" is defined by KRS 216B.015(13).
Part B" means a part of the Uniform Application for Provider Credentialing
and Recredentialing that implements the requirements of KRS 304.17A-545(5) and
is incorporated by reference in 806 KAR 17:480.
"Reevaluation" or "recredentialing" means a process for
identifying a change that may have occurred in a health care professional’s
qualifications since the last evaluation or credentialing.
Section 2. Health
Care Provider Credentialing Requirement. (1) A health care provider that is
required under KRS 304.17A-545(5) to perform credentialing or recredentialing
activities of a health care professional on or after July 1, 2007 shall use
Form KAPER-1, Part B, for evaluation of the credentials of health care
professionals for whom the health care provider requires credentialing.
(2) Pursuant to
subsection (1) of this section, a health care provider shall:
(a) Have a
mechanism for making available and accepting from a health care professional a
handwritten or electronically submitted Form KAPER-1, Part B, for:
(b) Within ninety
(90) days of receipt of a Form KAPER-1, Part B:
1. Notify the
health care professional that the Form KAPER-1, Part B, is complete or that
omitted or questionable information is included on the form; and
assistance to the health care professional, if applicable; and
(c) Within 180
days of receipt of a complete Form KAPER-1, Part B, provide a final
determination and notification electronically or in writing to a health care
professional of the status of his credentialing. This time period shall be
extended if, due to extenuating circumstances:
1. Additional time
is required by the health care provider to consider information submitted on
the Form KAPER-1, Part B; and
2. The health care
professional is informed of the need for additional time and reason for the
(3) A health care
provider that performs credentialing activities shall not require the health
care professional to provide information on Form KAPER-1, Part B, which is not
relevant to the professional competence, conduct, character, scope of practice,
health care setting, or service of the health care provider.
(4) The health care provider
shall not be prohibited from obtaining from a health care professional
supplementary credentialing materials, an original signature, or accepting an
electronic signature of the Form KAPER-1, Part B. (33 Ky.R. 2245; 3220; 3401;