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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  1. Whereas, access to medical care is a crisis in our country and in Maryland; and
  2.  
  3. Whereas, physicians want to treat patients with Medicaid and/or Medicare coverage; and
  4.  
  5. Whereas, physicians who have already been credentialed and approved for participation in traditional
  6. Medicaid and/or Medicare are not automatically credentialed for managed care plans and products in
  7. Maryland; and
  8.  
  9. Whereas, this additional credentialing administrative burden and delays makes it impossible for
  10. physicians to provide care to Medicaid and Medicare managed care patients; and
  11.  
  12. Whereas, the current managed care process of limiting networks does not benefit access to care and only
  13. benefits large corporations; and
  14.  
  15. Whereas, access to care will be improved significantly by requiring Medicaid and Medicare managed
  16. care plans and payors to accept credentialing decisions of traditional Medicaid and Medicare, therefore, be it
  17.  
  18. RESOLVED, that MedChi seek and/or support legislation or regulation to require Medicaid and
  19. Medicare managed care plans and payors in the State of Maryland to allow all physicians to
  20. participate in their panels if the physician has already been credentialed by Medicaid or Medicare
  21. to accept these patients; and be it further
  22.  
  23. RESOLVED, that the MedChi American Medical Association delegation submit a resolution to the
  24. AMA House of Delegates if federal law needs to be amended to require Medicaid and Medicare
  25. managed care plans and payors to allow all physicians to participate in their panels if the physician
  26. has already been credentialed by Medicaid or Medicare to accept these patients with Medicaid and/or Medicare coverage.