Michigan House Bill HB5344

Michigan 2023-2024 Regular Session

• Introduced: 11/14/23
• Refer: 11/14/23

Caption

Insurance: health benefits; nonprofit health care corporation to panel a mental health provider within a certain time period of the application process; require. Amends 1980 PA 350 (MCL 550.1101 - 550.1704) by adding sec. 414c. TIE BAR WITH: HB 5343'23

Impact

The provisions outlined in HB 5344 have the potential to significantly improve access to mental health services by facilitating quicker participation of qualified providers in health care plans. Moreover, it requires health care corporations to reimburse providers for services rendered during the application review period, thereby addressing a critical issue of financial support for those waiting for approval. This could incentivize more qualified mental health professionals to apply for participation in health care corporations, ultimately leading to increased service availability.

Summary

House Bill 5344 aims to amend the Nonprofit Health Care Corporation Reform Act by adding a new section 414c, which establishes requirements for the credentialing process of mental health and substance use disorder providers. The bill mandates that health care corporations assess and verify the qualifications of these providers within 60 calendar days of receiving a complete credentialing application. The stipulations are intended to streamline and expedite the process for providers seeking to participate in health care networks, ensuring timely decisions on their applications.

Contention

Although the bill appears beneficial by promoting quicker credentialing and reimbursement, it may also raise concerns among some health care corporations about the administrative burden and accountability. For instance, if a credentialing application is not processed within the stipulated timeframe, health care corporations may face increased costs for retroactive reimbursements. Additionally, there may be pushback regarding how exceptions to the 60-day rule are implemented, particularly if additional scrutiny of an applicant's qualifications is deemed necessary due to legal or regulatory issues.