House committee passes bill aimed at health care
Local lawmakers say changing the credentialing process for health practitioners could address delays by insurers for inclusion in their networks.
The state House Health Committee recently approved legislation to address the issue.
“When talking with those in the health care field about what barriers they face when seeking employment, the amount of time in the credentialing process has been identified again and again,” state Rep. Clint Owlett, R-Wellsboro said. “If we want to attract talented physicians to Pennsylvania and save our smaller rural hospitals money, then we need to make the transition of new physicians as smooth and as quick as possible. Right now some doctors are waiting up to six months to be credentialed.”
Owlett, the bill’s sponsor, said newly hired health care professionals fully licensed and qualified to provide care too often are not reimbursed by insurers for months while the insurers work their way through an unnecessarily long and cumbersome credentialing process. Not only does this cost hospitals, physician practices and community health centers money, it also limits access to care by keeping fully licensed and qualified providers unable to provide care until they are credentialed by insurers.
House Bill 533, would require all health insurers in Pennsylvania to accept The Council for Affordable Quality Healthcare’s credentialing application or another nationally recognized credentialing application designated by the Insurance Department. Health insurers would then have 45 days to complete the credentialing process after receiving the application.
State Rep. Garth Everett, R-Muncy, called the issue a real problem.
“It seems to take an excruciatingly long time,” he said. “These people are qualified.”
Everett said he’s unaware if the situation is unique to Pennsylvania.
“This is all about improving the process in order to put skilled practitioners to work quicker,” Owlett said. “I am pleased members of the Health Committee recognize this as an area in the system that needs to be improved upon, and I look forward to a vote by the full House in the near future.”
UPMC Susquehanna officials declined comment for this story.