HEALTH INSURANCE CREDENTIALING

HB 136 requires New Mexico's Health Care Authority to create a centralized credentialing system for Medicaid managed care providers, so providers submit one application to the Authority instead of multiple applications to different Medicaid plans. Medicaid managed care contractors must review applications within 30 days (extendable by 15 days for specific cases) and load approved provider information into their payment systems within that timeframe. The bill also limits re-credentialing to once every three years after initial approval. This directly affects Medicaid managed care providers and the contractors that manage Medicaid plans.