California2026Enacted

AB-1041

Health Care Provider Credentialing Rules

Last scannedAug 24, 2026, 7:05 AM

In one sentence

Starting in 2028, health plans and insurers must use a standard form to check provider qualifications and decide on applications within 90 days.

Requires full-service health care service plans and health insurers (or their delegates) to use the Council for Affordable Quality Healthcare credentialing form starting January 1, 2028.
Sets a limit of 90 days for these companies to make a decision on a provider's credentials after receiving a complete application.
Requires providers to be activated in the network upon successful approval and notified about their activation status as specified by law.
Mandates provisional approval of an applicant's credentials for 120 days if the company fails to meet the 90-day deadline, unless specific exceptions apply such as discipline from a licensing entity.
Excludes Medi-Cal managed care plans from these new credentialing time limits and form requirements.

The law does not apply to Medi-Cal managed care plans.
Provisional approval is not required if the applicant faces discipline from their licensing entity, though other unspecified exceptions may also exist.
The exact details of how activation and notification must occur are described as 'as specified' in the bill.

Plain language

Credentialing form: A standard document used by health companies to collect and check a provider's qualifications.
Provisional approval: Temporary permission for a provider to work in the network while waiting for a final decision if deadlines are missed.
Delegate: A person or group hired by an insurance company to handle tasks like checking provider credentials.

Official record

Source attached

Health care coverage: health care provider credentials.

Official activity