House Bill Would Address Problems with Health Professionals’ Credentialing Process
February 22, 2019
HAP is supporting legislation to improve Pennsylvania's credentialing process for health care practitioners. House Bill 533, introduced by Representative Clint Owlet (R-Tioga), addresses unwarranted delays by health insurers in credentialing applicants for inclusion in their networks.
House Bill 533 mirrors legislation that passed the House unanimously last session, which provided for the use of a credentialing application that health care providers would be required to use when seeking to become credentialed by a health insurer.
In addition to HAP, the bill was supported by the Pennsylvania Medical Society, the Coalition of Nurse Practitioners, the Pennsylvania Academy of Family Physicians, and the Pennsylvania Association of Community Health Centers.
Hospitals, physician practices and community health centers across the state often face problems with the current credentialing process. The problematic process impacts access to care for patients and affects reimbursement for providers. A newly hired health care professional, who is fully licensed and qualified to provide care, may not be reimbursed by an insurer for months while the insurer works its way through a long and cumbersome credentialing process. The process can take up to six months.
HAP will encourage lawmakers to advance the measure. For additional information, contact Stephanie Watkins, HA’s vice president, state legislative advocacy.