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Committee releases bill to streamline physician credentialing; insurers and hospitals flag tradeoffs

June 12, 2025 | 2025 Legislative Sessions, New Jersey


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Committee releases bill to streamline physician credentialing; insurers and hospitals flag tradeoffs
The Assembly Regulated Professions Committee voted to release Assembly Bill 5,713, a measure intended to streamline credentialing of physicians for participation in health insurers’ provider networks by allowing approval when a New Jersey medical license is in good standing.

Sponsor remarks at the committee said the bill would reduce delays that impede patient access to in‑network care and help address workforce shortages. The committee heard testimony from insurers, hospitals and advocacy groups weighing the benefits of faster approvals against consumer‑protection and vetting concerns.

Ward Sanders (Ward Spencer in the transcript), representing the New Jersey Association of Health Plans, testified in opposition and cautioned that the credentialing process serves as a vetting mechanism. He described the carrier review process as including standardized applications and primary source verifications and said the review identifies red flags such as disciplinary actions or incomplete work histories. “There’s a concern that in trying to address the speed with which these applications are reviewed that we’re losing some of the consumer protections,” Sanders said.

Hospital representatives, including Neil Iker of the New Jersey Hospital Association and James Darley of the Fair Share Hospitals Collaborative, testified in favor, describing lengthy credentialing delays that can leave employed physicians unable to see patients. Iker cited an analysis showing most applications processed within 60 days but said a subset—about 5%—averaged 284 days, and that 13 carriers each took more than 100 days for credentialing reviews in one hospital’s tracking.

Committee members asked about existing time frames and processes: the Department of Banking and Insurance’s guidance gives carriers 45 days to deem an application complete and 90 days to make a determination; witnesses described iterative back‑and‑forth verification steps (primary source verification of degrees, work history, disciplinary records) and variations across carriers. Witnesses and members also discussed delegated credentialing arrangements in which carriers delegate credentialing to hospitals under oversight agreements.

Action: the committee voted to release Assembly Bill 5,713. Testimony and committee discussion indicated willingness to work with carriers and hospitals to preserve consumer protections while reducing administrative delays. The bill will proceed for additional legislative consideration and potential amendments.

The committee posted included sponsor remarks, insurer testimony warning against unintended weakening of vetting standards, and hospital testimony emphasizing access and operational impacts from credentialing delays.

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