What physicians need to know

Colorado Medical Society partnered with the Colorado Association of Health Plans (CAHP) and Colorado Medical Group Management Association (CMGMA) to streamline the credentialing process from beginning to end.

This bill takes effect Aug. 6, 2026.

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What does the bill do? — SB21-126 addresses the issue of delayed physician credentialing, which can compromise patient access to care by impacting in-network availability of critical providers. The bill establishes a timeline Colorado-regulated health plans are required to follow, as well as accessible applicant information and up-to-date provider network directories.

What can physicians expect from the law? — If you are applying for credentialing with a health plan regulated by the Colorado DOI, you can expect your application process to follow this timeline:

• Day 0: You submit a credentialing application to a health plan.
• Day 7: The carrier will notify you that they received the application.
• Day 10: If your application is incomplete, the carrier has until this day to notify you and provide a complete and detailed list of what is required to complete your application.
• Day 60: The carrier must conclude processing your application and notify you of your newly credentialed status.
• If the carrier fails to notify you within the required timeframes and your application is complete, the applicant shall be considered a participating provider no later than 53 days from initial receipt.

Accessible information: Carriers and physicians also have responsibilities under SB21-126 to ensure information is accessible and up-to-date:

• Carriers must correct discrepancies in the network plan directory within 30 days of a report of the discrepancy from a participating physician. Physicians must notify carriers of any changes to their directory information within 15 days of the change.
• All credentialing criteria must be made available by the carrier to all applicants and clearly posted on their website.

Maintaining a credentialed status:

• A participating provider remains credentialed unless the carrier discovers information that the provider no longer meets their participation guidelines. Notification of a change in credentialing status must be made in writing with an explanation.

How Did We Get Here? — After CMS learned from members and stakeholders that the credential process often took 70, 90, or even 120 days – creating unnecessary burden for physician practices and financial and health liability for their patients needing to access critical physicians in a timely manner – we worked closely with CAHP and CMGMA to create SB21-126. After two years of negotiations, the bill was introduced in the legislature to broad, bipartisan support and was signed by the governor.