- Key Takeaways
- AB 1041, authored by Assemblymember Bennett, was signed into law October 11, 2025 as Chapter 630, Statutes of 2025. It amends both the Health and Safety Code (for health plans) and the Insurance Code (for health insurers).
- Starting January 1, 2027, DMHC-regulated health plans and CDI-regulated health insurers must decide on a completed credentialing application within 90 days, with receipt acknowledged within 10 business days.
- If a plan misses the 90-day deadline, it must provisionally approve the provider for 120 days, with limited exceptions (licensing discipline, NPDB adverse action or malpractice reports, or no credentialing history with that plan in the past 5 years).
- Starting January 1, 2028, full-service plans and insurers must adopt and use the most recent CAQH credentialing form, reducing duplicate paperwork across payers.
- Medi-Cal managed care plans are excluded. Mental health and substance use disorder providers keep their existing, separate 60-day credentialing timeline under prior law.
What Is AB 1041?
AB 1041 is a California law that standardizes how health plans and health insurers credential providers. Signed October 11, 2025 as Chapter 630, Statutes of 2025, it was authored by Assemblymember Bennett and adds parallel provisions to two different codes: Health and Safety Code Sections 1374.198 and 1380.2 for DMHC-regulated health plans, and Insurance Code Sections 10144.565 and 10110.9 for CDI-regulated health insurers.
The law addresses two long-standing provider complaints: credentialing timelines that vary widely by plan, and every payer requiring its own version of a credentialing application even when CAQH already maintains a standardized one.
Who AB 1041 Applies To
- DMHC-regulated health care service plans
- CDI-regulated health insurers
- Full-service plans and insurers, specifically for the CAQH form requirement
- The plan or insurer’s delegate, meaning IPAs, medical groups, and MSOs that credential providers on a plan’s behalf are covered as well, not exempt
Excluded:
- Medi-Cal managed care plans
- Mental health and substance use disorder credentialing, which already operates on a separate 60-day timeline under existing law and is not changed by AB 1041
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Neolytix manages the complete credentialing lifecycle from primary source verification to payer approvals and revalidation, ensuring your providers are enrolled accurately and activated without unnecessary delays.
Key Requirements and Deadlines
Effective date | What changes | Governing section |
January 1, 2027 | Plans and insurers must decide on a completed credentialing application within 90 days, and acknowledge receipt (and completeness) within 10 business days. Missing the deadline triggers 120-day provisional approval, with limited exceptions. | Health & Safety Code §1374.198; Insurance Code §10144.565 |
January 1, 2028 | Full-service plans and insurers must subscribe to and use the most recent CAQH credentialing form and minimize duplicate information requests. | Health & Safety Code §1380.2; Insurance Code §10110.9 |
The 90-day timeline covers the credentialing determination only. It does not include the time it takes to finalize a contract once credentialing is approved, so providers should not expect a 90-day credentialing decision to mean a 90-day path to billing.
What This Means for Providers
- The 90-day clock does not start until the application is confirmed complete. Plans have 10 business days to acknowledge receipt and confirm whether an application is complete. An incomplete application does not start the countdown, so accuracy on submission matters more under this law, not less.
- Two more 10-day clocks run alongside it, in different directions. Once a plan approves a provider, it must notify and activate that provider within 10 days. Separately, when a plan requests supplemental information mid-review, the provider has 10 business days to respond. Missing that window on the provider side can stall an otherwise clean application even though the plan is the one facing the 90-day deadline.
- Provisional approval is a real fallback, with real exceptions. A missed deadline does not guarantee provisional approval. Providers with recent licensing discipline, NPDB-reported adverse actions or malpractice payments, or no prior credentialing history with that specific plan in the last 5 years do not qualify.
- CAQH accuracy becomes more consequential in 2028. Once plans are required to pull from a single standardized CAQH form, an out-of-date or incomplete CAQH profile becomes a bottleneck across every payer relationship at once, not just one.
- Delegated credentialing arrangements are covered too. Because the law applies to the plan “or its delegate,” IPAs, medical groups, and MSOs credentialing on a health plan’s behalf are subject to the same 90-day and CAQH requirements as the plan itself.
- The 60-day behavioral health timeline is unaffected. Practices credentialing both medical and behavioral health providers should expect two different clocks to keep running, not one unified timeline.
How InCredibly Helps California Practices Get Ahead of AB 1041
AB 1041 raises the cost of a disorganized credentialing file. Once CAQH becomes the standardized intake for every plan in 2028, a stale attestation or a missing document does not just slow down one payer relationship, it becomes a bottleneck across all of them at once. This is precisely the problem InCredibly, Neolytix’s provider data intelligence platform, is built to solve.
InCredibly is built on Neolytix’s managed credentialing and enrollment operations, not sold as standalone software a practice has to implement and staff on its own. Where most credentialing tools track application status, InCredibly captures the full provider data lifecycle, meaning every transition a provider moves through: application submitted, primary source verification complete, committee review, payer approval, activation, and every expirable that follows (licenses, board certifications, malpractice coverage, DEA registration). That distinction matters under AB 1041 specifically, because the law creates multiple deadlines running at once (the plan’s 90-day clock, the provider’s 10-day response window, the eventual CAQH standardization), and a system that only shows “in progress” cannot tell a practice which of those clocks is actually at risk.
What InCredibly delivers today:
- A single, current view of provider data across every payer, instead of a CAQH profile and a dozen payer-specific files that drift out of sync with each other.
- Proactive expiration tracking for licenses, certifications, and other credentialing documents, so a lapse does not surface for the first time when a plan’s supplemental information request starts a 10-day clock.
- Audit-ready documentation aligned to NCQA and payer delegation standards, relevant for any group operating as a delegate under AB 1041’s “plan or its delegate” language.
- Multi-entity visibility for groups, MSOs, and BPOs credentialing across multiple payers or locations, so portfolio-level readiness for the 2027 and 2028 deadlines is visible in one place rather than reconstructed payer by payer.
Conclusion
AB 1041 gives California providers something they have not had before: a firm, statewide floor on how long a health plan can sit on a credentialing application, and eventually, one standardized form instead of a different version for every payer. Neither deadline is active yet. The 90-day requirement takes effect January 1, 2027, and the CAQH form mandate follows a year later. That gap is a preparation window, and the practices that use it to clean up CAQH profiles and credentialing documentation now will feel the least friction when both deadlines land.
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Frequently Asked Questions
What is AB 1041?
AB 1041 is a California law, signed October 11, 2025, that sets a 90-day credentialing decision deadline for health plans and insurers and later requires them to use a standardized CAQH credentialing form.
When does AB 1041 take effect?
The 90-day decision and 10-business-day acknowledgment requirements take effect January 1, 2027. The CAQH standardized form requirement takes effect January 1, 2028.
Does AB 1041 apply to Medi-Cal?
No. Medi-Cal managed care plans are excluded from AB 1041.
What happens if a health plan misses the 90-day deadline?
The plan must provisionally approve the provider’s credentials for 120 days, unless the provider has active licensing discipline, NPDB-reported adverse actions or malpractice payments, or has not been credentialed by that plan in the past 5 years.
Does AB 1041 change mental health or substance use disorder credentialing timelines?
No. Those providers keep their existing 60-day credentialing timeline under prior law, unaffected by AB 1041.
