NY S03943

Requires health care plans and insurers to notify health care professionals within 60 days of application submission whether they are credentialed or need additional time, with a final determination within 21 days of receiving necessary documentation.

Establishes "provisional credentialing" for newly-licensed or relocated health care professionals whose applications are neither approved nor declined within 60 days, allowing them to participate in the network while the credentialing process continues (except physicians cannot serve as primary care physicians until fully credentialed).

Changes the hearing panel for contract termination or non-renewal disputes from being appointed solely by the health care plan/insurer to a three-member panel with one member appointed by the plan/insurer, one by the health care professional, and one chosen by those two members, all licensed in the same profession as the professional under review.

Extends due process protections to cover both contract terminations and non-renewals, requiring written notice of reasons and opportunity for hearing at least 30 days before termination takes effect, with no termination effective earlier than 60 days from notice.

Prohibits health care plans and insurers from terminating or refusing to renew contracts solely because a provider advocated for a patient, filed complaints, appealed decisions, provided reports to regulators, or requested a hearing.