Bill > B26-0523

This bill amends the District of Columbia's health care provider credentialing process by requiring the Department of Health Care Finance to develop a single, consolidated application process for Medicaid providers seeking credentials with managed care organizations (MCOs) by January 1, 2027. The bill establishes new requirements for processing provider applications, including a mandate to return incomplete applications within 10 days and provide specific feedback, and requires the department to issue a temporary credential within 30 days of receiving a complete application from a provider with a valid professional license, with exceptions for providers who report malpractice claims, criminal records, or previous disciplinary actions. The bill also eliminates the need for providers to be recredentialed when they change employers or tax identification numbers, provided their new employer is part of an MCO provider panel, and requires MCO plans to upload provider information to billing platforms within 7 business days of the department issuing temporary credentials. The goal of the bill is to streamline the credentialing process, reduce administrative burden for healthcare providers, and ensure more efficient Medicaid provider enrollment across the District's managed care organizations.

Health and Social Services

https://lims.dccouncil.gov/Legislation/B26-0523