Health care provider credentialing.
The bill mandates that health care service plans, including Medi-Cal managed care plans, determine the credentials of health care providers within 90 days of receiving a completed application. Additionally, these plans must use the most current version of the Council for Affordable Quality Healthcare (CAQH) credentialing form by January 1, 2028. The intention behind these requirements is to ensure that health care providers are credentialed more efficiently, potentially reducing barriers to care for patients and expediting provider entry into healthcare networks.
Assembly Bill 2457, introduced by Assembly Member Connolly on February 20, 2026, aims to amend Sections 1374.198 and 1380.2 of the Health and Safety Code, focusing on health care provider credentialing. The bill extends existing credentialing requirements, initially applicable only to full-service health care service plans, to include Medi-Cal managed care plans. This change signifies an effort to streamline the credentialing process for healthcare providers and standardize practices across different healthcare plans operating within the state.
There may be some contention surrounding the implications of this bill among stakeholders. Proponents argue that standardizing the credentialing process will help resolve delays in provider approvals and enhance patient access to care. However, opponents might voice concerns regarding the adequacy of safeguards for maintaining high-quality standards in provider credentialing, particularly if the expedited timelines lead to insufficient vetting of providers. Furthermore, the imposition of criminal penalties for willful violations of the act could be seen as a deterrent that maintains accountability but may also raise concerns from health care plans regarding compliance costs and legal ramifications.