26-373 New California Credentialing Requirements Under AB 1041: Phased Implementation (2026-2028)
Date: 03/31/26
Mandatory CAQH submission begins January 1, 2028
California Assembly Bill (AB) 1041 introduces new standards for provider credentialing that apply to all full‑service healthcare service plans and health insurers, including Health Net* and its credentialing delegates. These changes are designed to streamline the credentialing process, reduce administrative burden and create greater consistency across California health plans.
Beginning January 1, 2028, credentialing and recredentialing applications must be submitted using the most recent version of the Council for Affordable Quality Healthcare (CAQH) standardized credentialing form, as required by AB 1041. The information below outlines what Health Net is required to comply with and what these changes mean for you as a participating provider.
Key dates to know
- October 2026: Health Net operational readiness target to align with AB 1041 credentialing timeline requirements, which must be implemented within one year of the law’s enactment.
- January 1, 2028: CAQH becomes the required submission method for all credentialing and recredentialing applications.
Health Net requirements under AB 1041
Health Net and its credentialing delegates must:
- Use the CAQH credentialing form for all credentialing and recredentialing applications beginning January 1, 2028.
- Make credentialing determinations within 90 calendar days of receiving a complete application.
- Provisionally approve eligible physicians, practitioners and other providers for up to 120 calendar days when credentialing timelines are exceeded and statutory conditions are met unless:
- The physician, practitioner or other provider has disciplinary actions from a licensing board.
- There are adverse actions or malpractice reports in the National Practitioner Data Bank.
- The physician, practitioner or other provider has not been credentialed by Health Net within the past five years.
- Activate approved physicians, practitioners and other providers promptly and notify them within 10 business days of activation.
- Limit requests for additional information to only what is necessary to clarify or verify CAQH application details.
Requirements for physicians, practitioners and other providers
To comply with AB 1041, physicians, practitioners and other providers must:
- Maintain a current, complete and accurate CAQH profile.
- Attest in CAQH according to CAQH standards.
- Submit all credentialing and recredentialing applications exclusively through CAQH beginning
January 1, 2028. - Respond to requests for additional information within 10 business days to avoid processing delays.
- Keep required documents up to date in CAQH, including:
- Active licenses
- Malpractice insurance
- Work history
- Any required supporting documentation
- Incomplete, inaccurate or outdated information may delay Health Net’s credentialing decision.
Accessing and managing your CAQH profile
Physicians, practitioners and other providers can access and manage their credentialing information through CAQH ProView at Provider Data Portal.
Physicians, practitioners and other providers without an existing CAQH ID must complete the registration process before signing in. Once registered, you can upload documents, maintain your profile and attest to the accuracy of your information as required.
Prepare now to avoid disruptions
Health Net strongly encourages physicians, practitioners and other providers to register for CAQH or begin actively maintaining their CAQH profile now. Early preparation will help ensure a smooth transition and full compliance when the new requirements take effect on January 1, 2028.
Need help? Contact us
If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email, by phone or through the Health Net provider portal.
Provider Services
Line of business | Phone number | |
|---|---|---|
Ambetter from Health Net IFP Ambetter PPO | ||
Ambetter HMO | ||
Health Net Employer Group HMO, POS, & PPO | ||
Behavioral Health providers | N/A |
This information applies to Physicians, Practitioners, Participating Physician Groups (PPGs), Hospitals, Ancillary Providers, and Behavioral Health Providers.