PA HB544

Health insurers in Pennsylvania must accept the CAQH (Council for Affordable Quality Healthcare) credentialing application or other Insurance Department-designated form from health care practitioners seeking to join provider networks

Insurers must notify practitioners within 10 business days whether their credentialing application is complete or incomplete, and must issue a credentialing determination within 45 business days of receiving a complete application

Practitioners approved for credentialing with multiple practice locations are automatically credentialed for all locations within the insurer's provider panel

The Insurance Department may assess administrative penalties on insurers that fail to use the required application or intentionally and routinely fail to meet credentialing timelines

The act takes effect in 180 days and does not guarantee practitioners the right to participate in any insurer network or require insurers to accept any willing provider