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State Law

Arizona Rev. Statutes-Title 20-Chapter 27-Article 1. General Provisions

07/28/2023 Arizona Section 20-3456

Covered services; claims

Credentialing-Payment Issues
State Law

Colorado Rev. Statutes-Title 10-Article 16-Part 7. Consumer Protection Standards Act for the Operation of Managed Care Plans

07/31/2023 Colorado Section 10-16-705.7

Timely Credentialing of Physicians by Carriers – Notice of Receipt Required – Notice of Incomplete Applications Required – Delegated Credentialing Agreements – Discrepancies – Denials of Claims Prohibited – Disclosures – Recredentialing – Enforcement – Rules – Definitions

Credentialing-Deadlines, Credentialing-Payment Issues, Directories
State Law

Indiana Code-Title 27-Article 8-Chapter 11-Accident and Sickness Insurance─Reimbursement Agreements

12/19/2024 Indiana Sections 27-8-11-1, 27-8-11-4.5, 27-8-11-7, 27-8-11-8, 27-8-11-9, 27-8-11-11, 27-8-11-13

Definitions; Permitted Disclosures by Providers; Coverage of Benefit or Service; Payment of Provider, Application; Provider Credentialing; Provider Directories; Preferred Provider Agreement Prohibitions; Insurer Payment to Insured for Service Rendered by Noncontracted Provider; Requirements; Fully Credentialed Provider Reimbursement; Requirements

Anti-gag clause, Anti-retaliation, Credentialing-Deadlines, Credentialing-Payment Issues, Directories, Most Favored Nation
State Law

Indiana Code-Title 27-Article 13-Chapter 43. Credentialing

12/19/2024 Indiana Sections 27-13-43-2 and 27-13-43-4

Provider Credentialing; Provisional Credentialing, Criteria, Reimbursement, Termination; Fully Credentialed Provider Reimbursement; Requirements

Credentialing-Deadlines, Credentialing-Payment Issues
State Law

Iowa Admin. Code-Insurance Division-Chapter 70. Utilization Review

08/04/2023 Iowa Section 191-70.10(514F)

Credentialing—retrospective payment

Credentialing-Payment Issues
State Law

KY. Rev. Statutes-Chapter 304-Subtitle 17A-Health Benefit Plans-Managed Care Plans

08/05/2023 Kentucky Section 304.17A-576

Notice by managed care plan insurer of health care provider’s application for credentialing–Payments to applicant.

Credentialing-Deadlines, Credentialing-Payment Issues
State Law

LA. Rev. Statutes-Title 22. Insurance

08/07/2023 Louisiana Section 22:1874

Billing by contracted health care providers

Credentialing-Payment Issues, Rental Networks
State Law

Maine Rev. Statutes-Title 24-A, Chapter 56-A, Subchapter 1. Health Plan Requirements

01/21/2025 Maine Section 4303

Plan requirements

Amendments, Anti-gag clause, Anti-retaliation, Continuity of Care Post-Contract, Credentialing-Deadlines, Credentialing-Due Process-Denial of Contract, Credentialing-Payment Issues, Fee Schedules, Most Favored Nation, Overpayments / Recoupments, Participation in Products, Plans, or Networks, Prohibited financial incentives, Retroactive Denial, Termination, Termination-Due Process
State Law

Maryland Statutes-Article 15. Insurance

08/07/2023 Maryland Section 15-112

Requirements applicable to a wide range of issues applicable to health care provider contracts

Anti-retaliation, Continuity of Care Post-Contract, Credentialing-Deadlines, Credentialing-Payment Issues, Directories, Fee Schedules, Most Favored Nation, Network Adequacy, Termination, Termination-Due Process