CaliforniaHealth care coverage: health care provider credentials.
What it does
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act's requirements a crime. Existing law provides for the regulation of disability and health insurers by the Department of Insurance.
More detail
This bill would require every full service health care service plan or health insurer, or its delegate, to subscribe to and use the Council for Affordable Quality Healthcare credentialing form on and after January 1, 2028, except as specified.
Existing law requires a health care service plan or disability insurer that provides coverage for mental health and substance use disorders and that credentials health care providers of those services for its networks to assess and verify the qualifications of a health care provider within 60 days after receiving a completed provider credentialing application.
This bill would, except as provided above and within one year of the bill's operative date, require every health care service plan or health insurer, or its delegate, that credentials health care providers for its networks to make a determination regarding the credentials of a provider within 90 days after receiving a completed provider credentialing application. The bill would require every health care service plan or health insurer to activate the provider upon successful approval and notify the applicant of the activation, as specified. If the health care service plan or health insurer, or its delegate, does not meet the 90-day requirement, the bill would require the applicant's credentials to be provisionally approved for 120 days unless specified circumstances apply, including that the applicant is subject to discipline by the licensing entity for that applicant. The bill would exclude Medi-Cal managed care plans from these provisions.
Because a willful violation of these provisions by a health care service plan would be a crime, this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Where do you stand?
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Where it stands
- Introduced
- Passed Assembly
- Passed Senate
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2025
- Oct 11Chaptered by Secretary of State - Chapter 630, Statutes of 2025.Latest
- Oct 11Approved by the Governor Gavin Newsom.Became Law
- Sep 16Enrolled and presented to the Governor at 2 p.m.To Governor
- Sep 9Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 67. Noes 2. Page 3115.).Major
- Vote recorded AB 1041 Bennett Concurrence in Senate Amendments. Result: pass.Lower
- Sep 8In Assembly. Concurrence in Senate amendments pending.
- Vote recorded 3rd Reading AB1041 Bennett et al. By Menjivar. Result: pass.Upper
- Sep 8Read third time. Passed. Ordered to the Assembly. (Ayes 30. Noes 1. Page 2587.).Passed Senate
- Sep 2Read second time. Ordered to third reading.Minor
- Aug 29Read second time and amended. Ordered returned to second reading.Major
- Vote recorded Do pass as amended. Result: pass.Upper
- Aug 29From committee: Amend, and do pass as amended. (Ayes 5. Noes 0.) (August 29).Major
- Aug 18In committee: Referred to suspense file.Minor
- Vote recorded Placed on suspense file. Result: pass.Upper
- Jul 7Read second time and amended. Re-referred to Com. on APPR.Major
- Jul 3From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 10. Noes 0.) (July 2).Major
- Jul 2
- Vote recorded Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations]. Result: pass.Upper
- Jun 24From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on HEALTH.Major
- Jun 18Referred to Com. on HEALTH.Minor
- Jun 4In Senate. Read first time. To Com. on RLS. for assignment.Minor
- Vote recorded AB 1041 Bennett Assembly Third Reading. Result: pass.Lower
- Jun 3Read third time. Passed. Ordered to the Senate. (Ayes 61. Noes 2. Page 2011.)Passed Assembly
- May 27Read second time. Ordered to third reading.Minor
- May 23Read second time and amended. Ordered returned to second reading.Major
- Vote recorded Do pass as amended. Result: pass.Lower
- May 23From committee: Amend, and do pass as amended. (Ayes 11. Noes 0.) (May 23).Major
- May 23Assembly Rule 63 suspended. (Ayes 51. Noes 16. Page 1644.)
- Apr 23In committee: Set, first hearing. Referred to suspense file.Minor
- Apr 8Re-referred to Com. on APPR.Minor
- Apr 7Read second time and amended.Major
- Apr 3From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 12. Noes 0.) (April 1).Major
- Apr 1
- Vote recorded Do pass as amended and be re-referred to the Committee on [Appropriations]. Result: pass.Lower
- Mar 10Referred to Com. on HEALTH.Minor
- Feb 21From printer. May be heard in committee March 23.
- Feb 20Read first time. To print.Introduced