| 1 | 1 | | 85R24846 LED-D |
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| 2 | 2 | | By: Muñoz, Jr. H.B. No. 2942 |
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| 3 | 3 | | Substitute the following for H.B. No. 2942: |
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| 4 | 4 | | By: Phillips C.S.H.B. No. 2942 |
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| 5 | 5 | | |
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| 6 | 6 | | |
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| 7 | 7 | | A BILL TO BE ENTITLED |
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| 8 | 8 | | AN ACT |
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| 9 | 9 | | relating to network adequacy standards adopted by the commissioner |
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| 10 | 10 | | of insurance for preferred provider benefit plans. |
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| 11 | 11 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 12 | 12 | | SECTION 1. Section 1301.0055, Insurance Code, is amended to |
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| 13 | 13 | | read as follows: |
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| 14 | 14 | | Sec. 1301.0055. NETWORK ADEQUACY STANDARDS. The |
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| 15 | 15 | | commissioner shall by rule adopt network adequacy standards that: |
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| 16 | 16 | | (1) are adapted to local markets in which an insurer |
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| 17 | 17 | | offering a preferred provider benefit plan operates; |
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| 18 | 18 | | (2) ensure availability of, and accessibility to, a |
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| 19 | 19 | | full range of contracted physicians and health care providers to |
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| 20 | 20 | | provide health care services to insureds; [and] |
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| 21 | 21 | | (3) on good cause shown, may allow departure from |
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| 22 | 22 | | local market network adequacy standards if the commissioner posts |
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| 23 | 23 | | on the department's Internet website the name of the preferred |
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| 24 | 24 | | provider plan, the insurer offering the plan, and the affected |
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| 25 | 25 | | local market; and |
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| 26 | 26 | | (4) hold insurers accountable for the networks the |
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| 27 | 27 | | insurers utilize and for any departure from network adequacy |
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| 28 | 28 | | standards. |
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| 29 | 29 | | SECTION 2. This Act takes effect September 1, 2017. |
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