The Streamlining Medicaid Credentialing Amendment Act of 2025 aims to create a centralized and standardized credentialing system for Medicaid providers in the District of Columbia. This legislation seeks to alleviate the burdens faced by qualified healthcare providers by consolidating the credentialing process under the Department of Health Care Finance (DHCF). Currently, each Medicaid Managed Care Organization (MCO) conducts its own credentialing, leading to inefficiencies, delays, and increased administrative costs. By implementing a single application process for credentialing and recredentialing, the bill intends to ensure that providers can deliver care more quickly and efficiently, ultimately improving access to healthcare for Medicaid recipients.

Key provisions of the bill include the establishment of a single application process for providers, the requirement for the DHCF to respond to applications within specified timeframes, and the issuance of temporary credentials to providers while their applications are being processed. Additionally, the bill stipulates that providers will not need to be recredentialed if they change employers, provided their new employer is a participating provider in the MCOs. The legislation also mandates that MCOs upload all relevant provider information to billing platforms within seven business days of the issuance of temporary credentials. These changes are designed to streamline the credentialing process, reduce delays in care, and enhance the overall efficiency of the healthcare delivery system in the District.