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A BILL TO BE ENTITLED
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AN ACT
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relating to adoption by the commissioner of insurance of network |
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adequacy standards for preferred provider benefit plans that |
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discourage balance billing. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1301.0055, Insurance Code, is amended to |
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read as follows: |
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Sec. 1301.0055. NETWORK ADEQUACY STANDARDS. The |
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commissioner shall by rule adopt network adequacy standards that: |
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(1) are adapted to local markets in which an insurer |
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offering a preferred provider benefit plan operates; |
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(2) ensure availability of, and accessibility to, a |
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full range of contracted physicians and health care providers to |
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provide health care services to insureds; [and] |
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(3) on good cause shown, may allow departure from |
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local market network adequacy standards if the commissioner posts |
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on the department's Internet website the name of the preferred |
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provider plan, the insurer offering the plan, and the affected |
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local market; and |
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(4) discourage balance billing as defined by Section |
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1456.001. |
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SECTION 2. This Act takes effect September 1, 2017. |