SF 359: Relating to the credentialing and recredentialing of Medicaid providers by a single state-procured credentialing verification organization

What it does

This bill requires the department of human services (DHS) to develop uniform authorization criteria for, and to utilize a request for proposals process to procure a single credentialing verification organization to be utilized in credentialing and recredentialing providers for the Medicaid managed care and fee-for-service payment and delivery systems. The bill requires DHS to contractually require all Medicaid managed care organizations (MCOs) to apply the uniform authorization criteria and to accept verified information from the single credentialing verification organization procured by the state, and to contractually prohibit the MCOs from requiring additional credentialing information from a provider in order to participate in the Medicaid managed care organization’s provider network.

Senate subcommittee · named February 26, 2019

• Sen. Mark Costello (R) · mark.costello@legis.iowa.gov
• Sen. Pam Jochum (D)
• Sen. Craig Johnson (R) · craig.johnson@legis.iowa.gov

Lobbying · 5 for, 1 against

For: Iowa Association of Rural Health Clinics; Iowa Behavioral Health Association (IBHA); Iowa Primary Care Association; Iowa Psychological Association; Lutheran Services in IA, Inc.

Against: Anthem, Inc. and Its Affiliates Including Amerigroup

In plain words

1. February 21, 2019Filed in the Senate and sent to the Human Resources committee
2. February 26, 2019Senate subcommittee named: Costello, Jochum and Johnson