HB1354: HB1354 Surprise Billing Consumer Protection Act; require certain health insurers providing a network plan to approve credentialing applications within a certain time frame

26 LC 52 1060S The House Committee on Budget and Fiscal Affairs Oversight offers the following substitute to HB 1354: A BILL TO BE ENTITLED AN ACT To amend Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to1 insurance generally, so as to require health insurers to implem ent a standardized2 credentialing application; to provide for health insurers to approve credentialing applications3 within a certain time frame; to provide for the Department of Insurance and the Department4 of Community Health to coordinate with stakeholders to establis h a standardized5 credentialing application; to provide for health insurers to utilize such application; to provide6 for rules and regulations; to provide for related matters; to provide for an effective date; to7 repeal conflicting laws; and for other purposes.8 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:9 SECTION 1.10 Chapter 24 of Title 33 of the Official Code of Georgia Annotate d, relating to insurance11 generally, is amended in Article 1, relating to general provisi ons, by revising Code12 Section 33-24-37, which is reserved, as follows:13 "33-24-37.14 (a) As used in this Code section, the term:15 H. B. 1354 (SUB) - 1 - 26 LC 52 1060S (1) 'Complete credentialing application' means the submission of a credentialing16 application and any supporting documents for a healthcare provider to a health insurer.17 (2) 'Credentialing' means to collect, verify, and assess wheth er a healthcare provider18 meets relevant licensing, education, and training requirements.19 (b) Every health insurer shall approve complete credentialing applications from healthcare20 providers within 45 days of receipt of any such application if submitted in accordance with21 the rules and regulations promulgated by the department.22 (c) The department and the Department of Community Health shal l coordinate with23 stakeholders to establish a standardized credentialing application for use in credentialing24 healthcare providers, which may be based on acceptance of data from or integration with25 the credentialing verification system used by the state Medicai d program to verify the26 qualifications, licenses, education, training, and professional history of healthcare27 providers.28 (d) No later than July 1, 2027, every health insurer shall uti lize the standardized29 credentialing application established pursuant to subsection (c) of this Code section.30 (e) No later than January 1, 2027, the department shall promulgate rules and regulations31 to implement the provisions of this Code section. Reserved."32 SECTION 2.33 This Act shall become effective July 1, 2026.34 SECTION 3.35 All laws and parts of laws in conflict with this Act are repealed.36 H. B. 1354 (SUB) - 2 -