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Senate hearing: bill would require insurers to pay in‑network rates during credentialing period for joining providers
Summary
The Senate Committee on Healthcare on April 17 heard testimony on House Bill 3242A, which would require insurers to reimburse providers joining an in‑network group at in‑network rates during the credentialing period, with an amendment letting insurers recoup differences if a provider fails to complete credentialing.
The Senate Committee on Healthcare on April 17 took public testimony on House Bill 3242A, which would require health insurers to reimburse providers who join an in‑network provider group at the insurer’s in‑network rate while the new provider completes the insurer’s credentialing process.
Representative Ed Deal, the House sponsor, described credentialing as the insurer verification process that can take up to 90 days and said the bill would prevent new providers working in established in‑network practices from being paid at out‑of‑network rates during that administrative window.
Representative Ed Deal said: “It requires health insurers during the credentialing period to pay providers who are joining an in‑network practice the same as they would pay in‑network providers. This assures patients are being served as quickly as possible and providers are fairly compensated.”
Hospital and physician organizations testified in support. Troy Duker of the Hospital Association of Oregon said the credentialing process can be time consuming and that the bill would help hospitals receive in‑network reimbursements for providers seeing patients while credentialing is pending. Mark Bonanno of the Oregon Medical Association said the bill was “an act of fairness” that would avoid paying new physicians less than their in‑network colleagues while administrative verification proceeds.
Both hospital and physician witnesses said they hoped the bill would also encourage insurers to speed credentialing. Representative Deal noted an amendment incorporated in the House that requires a provider group to reimburse a health insurer if the provider fails to submit a complete application or does not meet credentialing requirements, addressing insurer concerns about providers who never complete credentialing.
Supporters said the bill should increase access to care by reducing financial disincentives for new providers to begin seeing patients in in‑network clinics. Witnesses also emphasized that most credentialing applications are approved and that verification by state licensing boards provides primary-source information for insurers.
The committee received public testimony and closed the hearing on HB 3242A; no committee vote was recorded in the transcript.
