The bill amends Minnesota Statutes 2024, section 62Q.097, subdivision 2, to clarify the process and timeline for provider credentialing within health plan networks. It establishes that when a health plan company receives a clean application for provider credentialing, it must affirm the application's status and notify the provider or clinic of the determination date. If the application is not clean, the health plan must inform the provider of any deficiencies within three business days. Additionally, the bill stipulates that a determination on a clean application must be made within 45 days, with an allowance for an additional 30 days if substantive quality or safety concerns arise.

A significant insertion in the bill is the provision that once a health plan reviews and confirms an application as clean, the health care provider is classified as part of the health plan's provider network. This change aims to streamline the credentialing process and ensure that providers are promptly recognized within the network, enhancing access to care for patients.

Statutes affected:
Introduction: 62Q.097