Current through Register Vol. 54, No. 24, June 15, 2024
Section 9.762 - Credentialing standards(a) At a minimum, for PCPs and specialists, a plan shall verify the following credentialing elements:(2) Education and training.(3) Board certification status.(4) Drug enforcement administration certification status.(5) Current and adequate malpractice coverage.(6) Malpractice claims history.(8) Hospital privileges if the provider provides services at hospitals.(9) Any other information the Department may require.(b) A plan shall verify, at a minimum, for non-PCPs and nonspecialists, current licensure and malpractice coverage, to the extent licensure and coverage is required by State or Federal law. This section cited in 28 Pa. Code § 9.763 (relating to nonphysician providers at facility, agency or organizations).