18 Del. C. § 3308B: Provisional credentialing [Effective Jan. 1, 2028].

(a) Carriers must provide provisional credentials to health-care professionals who have submitted the uniform credentialing application from the date of notice of a clean application, effective until the credentialing application is approved or denied, under any of the following circumstances:

(1) When the carrier fails to make a credentialing decision on a clean credentialing application within the period required by § 6207(b) of this title.

(2) When the health-care professional’s primary employment is serving in a relevant health professional shortage area as designated by the U.S. Health Resources and Services Administration.

(3) When the health-care professional’s primary employment is within a federally-qualified health center.

(4) When the health-care professional is actively credentialed by the carrier at a different facility or location within Delaware.

(5) When the health-care professional is actively credentialed by the carrier in a different state with reciprocity of licensure to Delaware and relocating to Delaware or providing multistate care including care in Delaware.

(b) The carrier may not issue provisional credentialing if the health-care professional disclosed a history of malpractice settlements within 5 calendar years of the application or licensing board disciplinary actions in its uniform credentialing application.

(c) If, on completion of the credentialing process, the carrier denies an application for a health-care professional that has received provisional credentialing, the carrier may recover an amount equal to the reimbursements collected by the health-care professional within 120 days of the denial.