The Health Care Practitioner Credentialing Act establishes requirements for health insurers in Pennsylvania regarding the credentialing process for health care practitioners. Under this act, all licensed health insurers must accept the CAQH credentialing application or another form designated by the Insurance Department, provided it is nationally recognized. Health care practitioners are required to use the CAQH application, and the act outlines specific timelines for health insurers to notify practitioners about the completeness of their applications and to issue credentialing determinations. Additionally, if a practitioner is approved for credentialing at multiple locations, they will be automatically credentialed for all those locations.

The act also imposes penalties on health insurers that fail to utilize the CAQH application or do not complete the credentialing process as required. However, it clarifies that health insurers are not obligated to accept all willing health care providers into their networks, nor does it guarantee practitioners the right to participate in any insurer's network. The Insurance Department is tasked with creating rules and regulations to enforce the act, which will take effect 180 days after its passage.