MarylandSB 08082026 Regular SessionSenateWALLET

Health Insurance - Provider Panels - Requirements

Sponsored By: Nancy J. King (Democratic)

Signed by Governor

Health - InsuranceApplicants and ApplicationsCertificationsClassifications and DesignationsCommittees and CommissionsCommunications -see also- ElecComm; Intergov; etc.Data -see also- Census; DemographicsDental HealthElectronic CommunicationEvaluations and ReviewsFederal GovernmentFees -see also- Attys' Fees; Devt Fees & TaxesFormsHealth Insurance -see also- ACA; HMOs; MCOsHealth Maintenance Organizations -see also- Manage Care OrgsInsurance AdministrationInternet -see also- Internet AccessLiabilityManaged Care Organizations -see also- Health Maint OrgsMental and Behavioral Health -see also- Aut; Cogn; Dev; etc.Nonprofit OrganizationsNoticesPenalties and Sentences -see also- Death PenaltyPrivacyPrivate Schools -see also- Primary Schools; Secondary SchPublications -see also- Maryland Register; TextbooksPublic Schools -see also- Primary Schools; Secondary SchReimbursementsReportsRules and RegulationsTelephonesTimeTorts -see also-Med Malp; Wrongful Death

Personalized for You

How does this bill affect your finances?

Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.

Free to download

Bill Overview

Analyzed Economic Effects

5 provisions identified: 4 benefits, 1 costs, 0 mixed.

Faster, more accurate provider directories

When a participating provider reports a change, carriers must update the online directory within 2 working days. Carriers must use the designated online credentialing system as the main source to create and update their directories. The Commissioner only designates a multi‑carrier directory system if providers can update at least every 120 days (or on the Commissioner’s schedule) and the vendor does strong outreach to providers.

Faster, clearer credentialing for providers

Carriers must return incomplete applications within 10 days and say what is missing. Within 15 days of getting a complete application, they must send written notice saying they will keep processing or reject it. Most providers get a final yes or no within 60 days after the carrier says processing continues; listed behavioral health trainees and associates get a decision within 30 days of a complete application. Carriers must let you file the uniform form online, post a direct phone and email for credentialing questions, and answer within 2 business days. Missing the required notice violates the Insurance Article, and the uniform form must let you give access to a credentialing manager and also let you log in directly.

In‑network pay during credentialing

If your group practice employs a provider who applied to join a panel and the carrier says processing continues, the carrier pays your practice at the participating rate while it decides. The provider must have a valid Maryland license and at least one of these: hospital credentialing in Maryland, professional liability insurance, or immunity under the Federal or Maryland Tort Claims Act. Payments at in‑network rates run from the carrier’s required processing‑notice date until the final decision. After a rejection notice, services on or after that date are paid at nonparticipating rates.

Carriers may cap community providers

The law removes the ban that stopped carriers from limiting how many providers in certain categories they credential. Carriers may now set limits on behavioral health providers and providers at community clinics, local health departments, school‑based health centers, and other essential community providers. This can reduce access to care in some areas.

Start date and yearly tracking

This law takes effect January 1, 2027. The system vendor keeps a stakeholder workgroup and reports each year by September 1, including the average days each carrier takes from a complete application to a decision. Starting in 2027, the Commissioner reports to the General Assembly by December 1 each year on findings, improvements, and any legislative ideas.

Sponsors & Cosponsors

Sponsor

Nancy J. King
Democratic • Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 174 • No: 0

House vote • 4/13/2026

Third Reading Passed

Yes: 131 • No: 0 • Other: 9

Senate vote • 4/8/2026