S1236: Centralized Medicaid Provider Credentialing

Legislative Summary

Requiring Medicaid managed care organizations operating in this state on or after a specified date to require their providers to comply with specified accreditation requirements; requiring credentialing verification organizations to implement a single credentialing application through a web-based portal; providing that once approved for enrollment, a provider's claims become eligible for payment on the date on which the provider's credentialing application was approved; prohibiting Medicaid managed care organizations from requiring providers to appeal or resubmit clean claims submitted during a specified period, etc.