AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES -- HEALTHCARE PROVIDER CREDENTIALING

This bill requires healthcare entities and health plans to process provider credentialing applications within 30 calendar days for new applications and 10 business days for providers already credentialed with Medicare. It also mandates that minor demographic updates, such as address changes, be completed within 5 business days. The bill includes provisions for automated status updates every 15 days, written explanations for denials, and retroactive reimbursement if payers miss deadlines. Additionally, it establishes a conditional approval process for resident graduates and requires the health insurance commissioner to enforce timelines through quarterly reporting.