Current with changes from the 2024 Legislative Session
Section 15-103.4 - Credentialing of health care providers(a) A managed care organization may deem a health care provider credentialed for a period of not more than 6 months from the date of receipt of a completed application if: (1) The health care provider: (i) Has been credentialed by another entity in the State that is required to credential health care providers; and(ii) Has submitted an application to participate in the managed care organization's provider panel; and(2) The managed care organization verifies that the health care provider was credentialed and remains in good standing with at least one entity that credentialed the health care provider.(b) An entity that has credentialed a health care provider may not refuse a request by a managed care organization to verify that the health care provider is credentialed and in good standing.(c) Nothing in this section may be construed to relieve the managed care organization from fully credentialing its health care providers.