Michigan House Bill HB5512

Michigan 2025-2026 Regular Session

• Introduced: 2/5/26
• Refer: 2/5/26

Caption

Insurance: health insurers; procedures and timelines for the credentialing of health care providers; provide for. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406uu. TIE BAR WITH: HB 5513'26

Impact

The provisions of HB5512 aim to establish a clear and uniform process for credentialing health care providers, obliging insurers to adhere to specified timelines. Insurers are required to complete their credentialing decisions within 60 calendar days of receiving an application. If any application is deemed incomplete, insurers must inform the applicant within 30 days, thus ensuring that providers have the opportunity to address any deficiencies. This structured approach is intended to reduce delays commonly faced by health care providers seeking to join insurer networks.

Summary

House Bill 5512 seeks to amend the Insurance Code of 1956, specifically focusing on the credentialing process for health care providers by insurers in Michigan. The bill mandates that within seven calendar days of receiving a credentialing application, insurers must notify the applicant in writing or electronically about the receipt of their application and provide contact information for the person overseeing the application. This requirement aims to enhance transparency and communication between health care providers and insurers during the credentialing process.

Contention

While the bill is generally aimed at streamlining the process for health care providers, there may be points of contention related to insurers' ability to manage their networks and determine the necessity for additional providers. The restriction against denying credentialing based on the assertion that no additional providers are needed may raise concerns among insurers regarding their operational flexibility. Another potential source of debate could arise around the reimbursement requirements, where insurers must start providing payments for services retroactively to the completion date of the credentialing process, which could impact their cash flow management.