85R2658 LED-F
By: Muñoz, Jr. H.B. No. 2942
A BILL TO BE ENTITLED
AN ACT
relating to adoption by the commissioner of insurance of network
adequacy standards for preferred provider benefit plans that
discourage balance billing.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1301.0055, Insurance Code, is amended to
read as follows:
Sec. 1301.0055. NETWORK ADEQUACY STANDARDS. The
commissioner shall by rule adopt network adequacy standards that:
(1) are adapted to local markets in which an insurer
offering a preferred provider benefit plan operates;
(2) ensure availability of, and accessibility to, a
full range of contracted physicians and health care providers to
provide health care services to insureds; [and]
(3) on good cause shown, may allow departure from
local market network adequacy standards if the commissioner posts
on the department's Internet website the name of the preferred
provider plan, the insurer offering the plan, and the affected
local market; and
(4) discourage balance billing as defined by Section
1456.001.
SECTION 2. This Act takes effect September 1, 2017.