SF3705

Purpose

This bill aims to extend and strengthen how health plan companies credential and contract with mental health providers. It focuses on improving timely access to mental health services, especially for providers connected to certain types of organizations and in underserved or rural areas. The changes apply to a specific time period (July 1, 2023, through June 30, 2025).

Main Provisions

• Credentialing of providers from certain entities

  • If a health plan initially credentialed providers who are:
  • employed by or under contract with an entity that can bill under a specific Minnesota statute,
  • a mental health clinic certified under another statute,
  • designated an essential community provider, and
  • contracted with the health plan to provide mental health services, then the plan must continue credentialing at least the same number of providers from that entity as long as they meet the plan’s credentialing standards.

• Temporary credentialing and contracting to improve access (July 1, 2023 – June 30, 2025)

  • The health plan must credential and contract with any provider of mental health services who meets the plan’s credential requirements.
  • To speed access, the plan may waive credentialing requirements that are not directly related to quality of care, especially to help providers in underserved communities or in rural areas.
  • The contract must include:
  • usual and customary payment rates for the services,
  • confirmation that the provider is accepting new patients,
  • and that the provider is not already under an existing contract with the plan under a different tax ID (or, if already under contract under a different tax ID, the provider must have given notice of termination of that contract).

• Non-discrimination in credentialing

  • Health plans may not refuse to credential these providers because their network already has enough providers of that type or enough mental health providers in total.

Significant Changes

• Adds a temporary, expanded credentialing and contracting pathway specifically to improve mental health access during 2023–2025.
• Broadens the pool of providers eligible for credentialing and contracting by including providers connected to certain entities (e.g., clinics, essential community providers) and those who meet credential requirements.
• Allows waiving non–quality-related credentialing steps to facilitate access for underserved populations and rural areas.
• Reinforces that credentialing decisions should not be blocked simply because there are already enough providers in a given category.

Relevant terms - health plan company - credentialing - provider network - mental health services - essential community provider - mental health clinic certified under section 245I.20 - authorized to bill under section 256B.0625 subdivision 5 - July 1, 2023 – June 30, 2025 (timing window) - underserved communities - rural areas - usual and customary payment rates - accepting new patients - tax identification number (TIN) - waivers of credentialing requirements - no grounds of insufficient provider numbers (non-discrimination)