Bill

Bill > A5713


NJ A5713

Requires automatic issuance of credential to provide services in carrier provider network for physicians in good standing in New Jersey.


summary

Introduced
05/22/2025
In Committee
05/22/2025
Crossed Over
Passed
Dead

Introduced Session

2024-2025 Regular Session

Bill Summary

This bill requires approval of an application submitted for credentialing so a physician can participate in a carrier's provider network if the application demonstrates that the license of the physician issued by the State Board of Medical Examiners in New Jersey is in good standing. This also includes applications for the renewal of a credential. This is intended to streamline the credentialing process for physicians licensed in the State.

AI Summary

This bill modifies existing New Jersey law to require health insurance carriers (companies that provide managed care plans) to automatically approve credentialing applications for physicians who have a license in good standing from the State Board of Medical Examiners. Under the proposed legislation, when a physician submits a universal application form to participate in a carrier's provider network, the carrier must approve the application if the physician's medical license is confirmed to be in good standing. The bill removes previous language that gave carriers 180 days to process such applications and instead mandates immediate approval, effectively streamlining the credentialing process for physicians. Carriers are still allowed to request additional information from applicants that is not duplicative of the standard universal application form. The bill will apply to all credentialing applications received on or after its effective date, with the goal of making it easier and faster for physicians to join health insurance provider networks in New Jersey.

Committee Categories

Business and Industry

Sponsors (1)

Last Action

Assembly Regulated Professions Hearing (14:00:00 6/12/2025 Committee Room 12, 4th Floor, State House Annex, Trenton, NJ) (on 06/12/2025)

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