Texas House Bill HB3270

Texas 2013 - 83rd Regular

Caption

Relating to preferred provider and exclusive provider network regulations; providing administrative sanctions and penalties.

Impact

The bill's impact on state laws primarily concerns the Insurance Code, as it adds new sections that define network adequacy requirements and the obligations of insurers regarding provider access. Insurers will be required to monitor their networks continuously, maintaining compliance with the newly established standards. Additionally, the bill outlines detailed procedures for insurers to follow when their networks do not meet adequacy standards, including submitting a local market access plan that addresses any deficiencies and provides remedies for affected insured individuals.

Summary

House Bill 3270 introduces significant updates to the regulations governing preferred provider and exclusive provider networks in Texas. The bill aims to enhance the adequacy and accessibility of healthcare services under preferred provider benefit plans. This includes establishing more stringent network adequacy standards that insurers must meet, ensuring that health care providers are available to meet the insurance needs of policyholders. The changes require a sufficient number of providers to be accessible and will introduce administrative sanctions for non-compliance, making it essential for insurers to maintain a robust provider network.

Contention

There are notable points of contention surrounding House Bill 3270. Supporters argue that the bill will ensure that consumers have access to necessary healthcare services without facing barriers due to inadequate provider networks. However, critics may raise concerns about the potential administrative burdens imposed on insurers, fearing that the cost of compliance could lead to higher premiums for consumers. Furthermore, the requirement for insurers to maintain updated data on provider availability raises questions about the effectiveness of enforcing these standards in practical scenarios.