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HF 3964

Requirement that health plan companies must credential and contract with certain providers of mental health services extended.

2025-2026 Regular Session Introduced by Robert Bierman and 3 co-sponsors

Health plans must credential and contract with any qualifying mental health provider to improve timely access, even waiving nonquality rules if needed.

Author added Moller
#insurance-health #mentalhealthandrelatedconditions
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WeVote Research Nonpartisan
Bill Summary · HF 3964

Summary of HF 3964 (2025-2026) – Minnesota

Purpose and intent

HF 3964 extends and clarifies requirements that health plan companies credential and contract with providers of mental health services. The bill aims to ensure timely, adequate access to mental health care by requiring credentialing and contracting with a broader or more streamlined set of providers, including those serving underserved or rural communities. The bill also preserves certain existing credentialing obligations for providers already credentialed through specific entities.

Key provisions and changes

  • Section 62Q.096 (Credentialing of Providers)
    • Subsection (a) Existing obligation preserved:
    • If a health plan initially credentialed individual providers who are employed by or under contract with an entity that:
      • is authorized to bill under Minn. Stat. § 256B.0625, subd. 5;
      • is a mental health clinic certified under Minn. Stat. § 245I.20;
      • is designated an essential community provider under Minn. Stat. § 62Q.19; and
      • is under contract with the health plan to provide mental health services;
    • then the health plan must continue to credential at least the same number of providers from that entity, so long as those providers meet the plan’s credentialing standards.
    • Subsection (b) New and expanded requirements for credentialing and contracting:
    • To ensure timely access, a health plan must credential and contract with any provider of mental health services who: 1) meets the health plan’s credentialing requirements (the plan may waive certain credentialing requirements not directly related to quality of care to improve access for underserved communities or rural providers); 2) applies for credentialing with the health plan; 3) agrees to the contract terms, including payment rates that are usual and customary for the services provided; 4) is accepting new patients; and 5) is not already under a contract with the health plan under a different tax identification number, or has notified the health plan if termination of an existing contract has occurred.
    • Subsection (c) Prohibits credentialing denial based on provider network sufficiency:
    • A health plan cannot refuse to credential these providers on the grounds that: 1) there are already a sufficient number of providers of that type, or 2) there are sufficient providers of mental health services in the aggregate.
    • Effective date:
    • The act states the effective date as “retroactively from June 30, 2025.”

Who/what is affected

  • Affects health plan companies operating in Minnesota that credential and contract for mental health services.
  • Particularly relevant to:
    • Providers employed by or under contract with entities eligible under the criteria listed in subsection (a) (e.g., entities authorized to bill under § 256B.0625, subd. 5; certified mental health clinics under § 245I.20; essential community providers under § 62Q.19).
    • Individual mental health providers seeking credentialing with health plans who were not already under contract, including those serving underserved or rural populations.
  • Beneficiaries/patients seeking mental health services, who would gain potential access to a broader pool of credentialed providers and possibly faster appointment availability.

Procedural and timeline considerations

  • Effective retroactively from June 30, 2025.
  • Requires health plans to:
    • maintain credentialing of existing providers from the specified entities (per subsection (a));
    • credential and contract with any qualifying new providers meeting credentialing requirements, including waivers of non-quality-related credentialing criteria to improve access in underserved or rural areas (subsection (b)(1));
    • ensure contracts include usual and customary payment rates (subsection (b)(3));
    • process providers who are accepting new patients and who are not already under contract under a different tax ID (subsection (b)(4)-(5)).
  • No explicit sunset or expiration; the retroactive effective date implies the requirements apply to credentialing activities from June 30, 2025 onward.

Notes for readers

  • The bill is sponsored by multiple legislators (including Co-sponsors Larry Kraft, Liz Reyer, and Robert Bierman) and introduced in the 94th Legislature.
  • The bill’s language emphasizes access, timeliness, and reducing administrative barriers for credentialing, while preserving existing credentialing continuity for providers tied to certain entities.

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

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