An Act providing for the use of certain credentialing applications and for credentialing requirements for health insurers; imposing penalties; and conferring powers and imposing duties on the Insurance Department.

HB 544, the Health Care Practitioner Credentialing Act, requires all health insurers in Pennsylvania to accept the CAQH credentialing application (or a nationally recognized alternative) for health care practitioners seeking to join insurer networks. It sets clear timelines: insurers must notify practitioners within 10 business days if an application is incomplete, and make a final credentialing decision within 45 business days of receiving a complete application. The bill also mandates automatic credentialing for practitioners with multi-location practices and imposes penalties on insurers that fail to use CAQH or delay the process. It does not guarantee network access but standardizes the application and review process for practitioners and insurers.