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.

This bill, the Health Care Practitioner Credentialing Act, requires Pennsylvania health insurers to accept the CAQH credentialing application or a nationally recognized alternative for health care practitioners seeking to join provider networks. It sets clear timelines: insurers must notify practitioners within 10 business days if an application is incomplete and issue a credentialing decision within 45 business days for complete applications. Insurers failing to comply may face administrative penalties, though the bill does not guarantee practitioners a spot in any insurer's network. The law applies broadly to most health insurers (including Medicaid managed care organizations) but excludes certain coverage types like accident-only or vision insurance.