Health insurance; physician reimbursements, credentialing.

Requires health insurers and other carriers that credential the physicians in their provider networks to establish reasonable protocols and procedures for reimbursing a physician who has submitted a completed credentialing application to a carrier, after being credentialed by the carrier, for health care services provided to covered persons during the period in which the applicant's completed credentialing application is pending. The measure establishes minimum requirements for such protocols and procedures. The measure also (i) provides that a carrier is not required to pay reimbursement at the contracted in-network rate for any covered medical services provided by the new provider applicant if the new provider applicant's credentialing application is not approved or the carrier is otherwise not willing to contract with the new provider applicant; (ii) specifies that if a payment is made by the carrier to a physician or any entity that employs or engages the physician for a covered service, the patient is only responsible for any coinsurance, copayments, or deductibles permitted under the insurance contract with the carrier or participating provider agreement with the physician; and (iii) requires new provider applicants to provide notice to covered persons in advance of treatment. Finally, the measure requires the Virginia Department of Health to revise and reenact the regulations regarding managed care health insurance plans.