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S 3799

Relates to access to adjoining property to make improvements or repairs

2025 Regular Session Introduced by Leroy Comrie and 3 co-sponsors

Requires carriers to use a universal physician credentialing form, publish timelines, and reimburse for services during credentialing to speed network participation.

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Bill Summary · S 3799

Summary — S.3799 (Introduced) — Physician credentialing for carrier provider networks

Status & procedural history
- Bill introduced in the Senate on October 21, 2024; referred to Senate Commerce Committee.
- Amended through versions S3799A/B/C, advanced and passed by both houses in 2025, and was RETURNED TO SENATE (latest listed action: 2025-06-13).
- Companion/related measures: A357/A5046; prior-session bills S1305, S8430.
- If enacted, the act takes effect on the 180th day after enactment.

Purpose
- To standardize, speed, increase transparency of, and provide administrative enforcement for the credentialing process that physicians use to join managed-care carrier provider networks in New Jersey.

Key provisions
1. Universal application and online disclosure
- Carriers that offer managed care plans must accept the statewide “universal physician application for participation” and renewal forms (per P.L.2001, c.88) for credentialing physicians and for credentialing physicians employed by hospitals/facilities seeking network participation.
- Carriers must publish the universal participation and renewal forms on their websites, plus an explanation of the credentialing process including a list of required documents and any relevant timelines.
- Carriers may request additional non-duplicative information beyond the universal form.

  1. Timelines and deemed completeness

    • A carrier committee reviewing a universal physician application must notify the applicant within 30 days after submission if the application is incomplete, specifying the missing information in writing.
    • If no such notice is given within 30 days, the application is deemed complete.
    • The committee must review a complete application within 30 days of receipt of the completed application.

  2. Interim reimbursement for approved applicants

    • If a physician delivers services to covered persons in a carrier’s network while awaiting credentialing, and the carrier subsequently approves the application, the carrier must reimburse the physician for services delivered as of the date the application was filed.

  3. Employer-change protection

    • A carrier may not require a new application or renewal solely because a physician already credentialed with the carrier changes employers or health care facilities within the State.

  4. Administrative enforcement; no private right of action

    • Health care professionals may report suspected credentialing violations to the Department of Banking and Insurance (DOBI).
    • DOBI must establish a complaints system, investigate, and enforce credentialing requirements; complaints must be filed within two years of discovery.
    • Carriers violating credentialing provisions are subject to civil penalties (amount to be determined by the commissioner) collected under the Penalty Enforcement Law.
    • The department has exclusive enforcement authority; the bill does not create a private right of action.

Who would be affected
- Physicians (applicants and those changing employers), hospitals and other health care facilities, managed-care carriers and their credentialing committees, patients/covered persons receiving care, and the Department of Banking and Insurance.

Potential impacts and considerations
- Seeks to shorten delays and reduce administrative barriers to physicians participating in networks, and to ensure physicians are paid for care provided while credentialing is pending (if application is later approved).
- Increases transparency by requiring published forms and processes.
- Concentrates enforcement authority with the DOBI and precludes private lawsuits for credentialing violations.
- Carriers retain limited ability to request supplemental (non-duplicative) information.

Compiled from official sources — confirm details with the bill’s official record.

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