Automatic Credentialing for Physicians for Medicaid/Medicare Managed Care Plans When Already Approved for Traditional Medicare and Medicaid
MEDCHI, THE MARYLAND STATE MEDICAL SOCIETY
HOUSE OF DELEGATES
INTRODUCED BY: Montgomery County Medical Society
SUBJECT: Automatic Credentialing for Physicians for Medicaid/Medicare Managed Care Plans When Already Approved for Traditional Medicare and Medicaid
REFERRED TO:
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- Whereas, access to medical care is a crisis in our country and in Maryland; and
- Whereas, physicians want to treat patients with Medicaid and/or Medicare coverage; and
- Whereas, physicians who have already been credentialed and approved for participation in traditional
- Medicaid and/or Medicare are not automatically credentialed for managed care plans and products in
- Maryland; and
- Whereas, this additional credentialing administrative burden and delays makes it impossible for
- physicians to provide care to Medicaid and Medicare managed care patients; and
- Whereas, the current managed care process of limiting networks does not benefit access to care and only
- benefits large corporations; and
- Whereas, access to care will be improved significantly by requiring Medicaid and Medicare managed
- care plans and payors to accept credentialing decisions of traditional Medicaid and Medicare, therefore, be it
- RESOLVED, that MedChi seek and/or support legislation or regulation to require Medicaid and
- Medicare managed care plans and payors in the State of Maryland to allow all physicians to
- participate in their panels if the physician has already been credentialed by Medicaid or Medicare
- to accept these patients; and be it further
- RESOLVED, that the MedChi American Medical Association delegation submit a resolution to the
- AMA House of Delegates if federal law needs to be amended to require Medicaid and Medicare
- managed care plans and payors to allow all physicians to participate in their panels if the physician
- has already been credentialed by Medicaid or Medicare to accept these patients with Medicaid and/or Medicare coverage.