Virginia Regulatory Town Hall
secretary
Health and Human Resources
Agency
Virginia Department of Health
Board
State Board of Health
Mandate 1041

Mandate Information
Mandate Title:
Health insurance carriers that credential physicians in their networks to establish protocols and procedures for reimbursing new provider applicants for health care services
Purpose of legislation
Chapter 703 (2018 Acts of Assembly) amended the Code of Virginia by adding § 38.2-3407.10:1, which requires health insurance carriers that credential physicians in their networks to establish protocols and procedures for reimbursing new provider applicants for health care services provided to covered persons during the period in which the applicant’s completed credentialing application is pending, provided that the new provider applicant is ultimately approved by the health insurance carrier.
Legislation mandating a change Chap 703 (2018)
VAC chapters to be amended
12 vac 5 - 408 : Regulation for the Certificate of Quality Assurance of Managed Care Health Insurance Plan (MCHIP) Licensees
Associated Regulatory Actions
Action 5379: Amend regulations to conform to Ch.703 of the 2018 Acts of Assembly and changes related to Provider Credentialing
Latest Stage: Fast-Track
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