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07/22/2024 05:28 PM
Pennsylvania House of Representatives
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?chamber=H&SPick=20230&cosponId=39474
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House Co-Sponsorship Memoranda

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House of Representatives
Session of 2023 - 2024 Regular Session

MEMORANDUM

Posted: January 24, 2023 10:32 AM
From: Representative Steven C. Mentzer
To: All House members
Subject: Health Care Practitioner Credentialing Act (Prior HB 2613)
 
In the near future, I plan to introduce legislation to improve the credentialing process in Pennsylvania for health care practitioners and address unwarranted delays by health insurers in credentialing applicants for inclusion in their networks.
 
Health care practitioners routinely face delays with the credentialing process, with both commercial and public insurers. Those who are already licensed and qualified to provide care are not reimbursed by insurers for months while the insurers work their way through an unnecessarily long and cumbersome credentialing process. Unwarranted delays in credentialing harms those practitioners we want to attract to the Commonwealth the most – recent graduates who are applying for associate positions in a health care practice and new practitioners in residency programs. Not only does this cost health care facilities money, but it also limits access to care by keeping fully licensed and qualified providers on the sidelines until they are credentialed by insurers. Current credentialing processes sometimes can take up to six months or more.
 
My legislation would require health care practitioners and insurers to use the Council for Affordable Quality Healthcare (CAQH) system for credentialing, limit the credentialing period to 45 days for complete applications and streamline the process for health practitioners practicing in multiple locations.
 
I hope you will join in co-sponsoring this important legislation. Thank you.

 



Introduced as HB1510