DHS and the PASSEs have been moving toward requiring therapy providers to be credentialed with both Medicaid (through the PASSEs) and commercial insurers as part of network adequacy and managed care requirements. This is consistent with national trends in Medicaid managed care.

Current status and outlook:
– PASSEs are contractually required by DHS to maintain credentialed provider networks with adequate capacity.
– Providers who are not credentialed with commercial insurers cannot bill those insurers when clients have commercial coverage, which creates coordination-of-care gaps.
– DHS has not issued a blanket mandate requiring all EIDT therapy providers to credential with all commercial insurers, but the managed care direction suggests this will continue to be a growing expectation.
– Providers are encouraged to begin the credentialing process with major commercial insurers (BCBS, Cigna, Aetna, UnitedHealthcare) proactively, as credentialing can take 3–6 months.

DDPA continues to monitor DHS guidance on credentialing requirements and will communicate updates to members as policy direction becomes clearer.