Texas Senate Bill SB779

Texas 2009 - 81st Regular

• Out of Senate Committee: 3/26/09
• Voted on by Senate: 4/9/09

Caption

Relating to expedited credentialing for certain individual health care providers providing services under a managed care plan.

Impact

The bill modifies Chapter 1452 of the Insurance Code by adding a new subchapter dedicated to the expedited credentialing. It establishes eligibility requirements for these providers and outlines the payment processes during the credentialing phase. As a result, it could significantly alter the operational dynamics within the managed care environment by reducing delays associated with the credentialing process for non-physician providers. This could lead to an increase in available healthcare services in various specialties, especially where physician access may be limited.

Summary

SB779 introduces an expedited credentialing process specifically designed for individual healthcare providers who are not physicians and are joining established professional groups with contracts in place with managed care plans. This legislation aims to address the timely inclusion of these healthcare providers into the managed care network, thereby facilitating quicker access to necessary healthcare services for enrollees, which is crucial for meeting healthcare demands effectively and efficiently. The expedited process would enable providers to start practicing sooner while awaiting full credentialing approval.

Contention

While supporters of SB779 argue that it enhances access to health services by allowing faster integration of qualified healthcare providers into managed care networks, there may be concerns regarding the oversight and verification of these expedited processes. Detractors may highlight potential risks, such as the possibility of substandard care if not all providers undergo thorough credentialing, as dictated by established protocols. Balancing the need for expedited processes with the requirement to maintain high healthcare standards is likely to be a key point of contention during discussions surrounding this bill.