HB 1354: Surprise Billing Consumer Protection Act; require certain health insurers providing a network plan to approve credentialing applications within a certain time frame

Currently there is no statewide deadline in Georgia law for how quickly health insurers must process a healthcare provider's paperwork to join their network, a process called credentialing. This bill fills that gap in Georgia's insurance code (O.C.G.A. § 33-24-37) by requiring every health insurer to approve a complete credentialing application within 45 days of receiving it, as long as it follows rules set by the Department of Insurance. The bill also directs the Department of Insurance and the Department of Community Health to work with stakeholders to build one standardized credentialing application, possibly linked to the system the state Medicaid program already uses to verify providers. Insurers would have to start using that standardized form by July 1, 2027, and the Department of Insurance must issue implementing rules by January 1, 2027. The overall law would take effect July 1, 2026.

• Sets a 45 day deadline for health insurers to approve a complete credentialing application from a healthcare provider once all required documents are submitted.
• Defines 'complete credentialing application' and 'credentialing' in Georgia insurance law for the first time in this section.
• Directs the Department of Insurance and the Department of Community Health to jointly develop one standardized credentialing application, possibly tied into the state Medicaid verification system.
• Requires all health insurers to switch to using that standardized application no later than July 1, 2027.
• Requires the Department of Insurance to write rules implementing the new law by January 1, 2027.

Health insurers that offer network health plans in Georgia, healthcare providers such as doctors and other practitioners applying to join insurance networks, the Department of Insurance, and the Department of Community Health, which must jointly build the standardized application.

Providers currently can face long, unpredictable waits before insurers approve them to join a network, which can delay patients' access to in-network care. A firm 45 day deadline and a single standard application could speed up how quickly new providers start seeing insured patients.

• Section 1 rewrites O.C.G.A. § 33-24-37 to define 'complete credentialing application' and 'credentialing.'
• Subsection (b) requires health insurers to approve complete credentialing applications within 45 days of receipt if submitted under department rules.
• Subsection (c) requires the Department of Insurance and Department of Community Health to coordinate with stakeholders to create a standardized credentialing application, possibly linked to the state Medicaid credentialing system.
• Subsection (d) requires all health insurers to use the standardized application by July 1, 2027.
• Subsection (e) requires the Department of Insurance to issue implementing rules and regulations by January 1, 2027.
• Section 2 sets the Act's effective date as July 1, 2026.

1. 2026-02-25House Committee Favorably Reported By Substitute (Cámara de Representantes)
2. 2026-02-20House Second Readers (Cámara de Representantes)
3. 2026-02-19House First Readers (Cámara de Representantes)
4. 2026-02-18House Hopper (Cámara de Representantes)

• Trey Kelley (R, HD-016)Patrocinador principal
• James Hatchett (R, HD-155)
• Mark Newton (R, HD-127)

• health insurance
• medical licensing
• provider credentialing
• surprise billing
• insurance regulation