Health benefit plans; prohibiting health benefit plan from requiring certain evidence. Effective date.
Impact
The legislation seeks to improve access to healthcare by reducing barriers within the credentialing and recredentialing processes. By limiting the criteria that health benefit plans can impose, the bill intends to ensure that a greater number of healthcare professionals can enter the market and provide necessary services to patients. Furthermore, it stipulates a timeline within which health benefit plans must process applications, thereby aiming to enhance the efficiency of provider enrollment.
Summary
Senate Bill 2011 focuses on regulating health benefit plans in Oklahoma, specifically addressing the credentialing process of healthcare providers. The bill prohibits health benefit plans from requiring certain evidence, such as malpractice liability insurance, as a condition for credentialing or recredentialing healthcare providers. This amendment aims to streamline the application process for physicians seeking to provide services under health benefit plans, making it less cumbersome and faster for providers to be credentialed and thus in-network for reimbursement.
Contention
Despite its intentions for streamlined healthcare access, SB2011 may generate contention among stakeholders. Proponents argue that the bill fosters inclusivity within the healthcare system by allowing more providers to practice without unnecessary delays or stringent requirements. However, opponents may express concerns regarding patient safety and quality of care, fearing that relaxing credentialing requirements could lead to a dilution of standards for healthcare providers. Additionally, the removal of malpractice insurance requirements might spark debates around accountability and protection for both patients and providers.
Health benefit plan directories; directing plans to publish certain information in a publicly accessible manner; requiring reporting to Insurance Commissioner. Effective date.
Health insurance; providing for preauthorization process; establishing processes for administration; prohibiting certain payment reduction to health benefit plans. Effective date.
Health insurance coverage; requiring health benefit plans to provide coverage for at home care for persons with certain conditions; specifying terms of coverage. Effective date.
Mental health and substance use disorder benefits; requiring certain plans and Medicaid provide reimbursement for care pursuant to collaborative care model; allowing for denial in certain circumstances. Effective date.
Health insurance; requiring certain high deductible health plans to allow an insured to set aside funds for medical expenses subject to certain limitations. Effective date.
Sexually transmitted infections; requiring health benefit plans to cover cost of certain serological tests; modifying required frequency of syphilis testing. Effective date.
Education employee health insurance benefits; increasing opt out amount received by certain personnel; requiring certain documentation. Effective date. Emergency.
Relating to the establishment of an advisory committee to develop a process for the collection of information necessary to facilitate physician credentialing by Medicaid managed care organizations.