Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
Subchapter X - PREFERRED AND EXCLUSIVE PROVIDER PLANS
Division 1 - GENERAL REQUIREMENTS
Section 3.3710 - Failure to Provide an Adequate Network

Universal Citation: 28 TX Admin Code § 3.3710

Current through Reg. 50, No. 13; March 28, 2025

(a) If the commissioner determines, after notice and opportunity for hearing, that the insurer's network and any access plan supporting the network are inadequate to ensure that preferred provider benefits are reasonably available to all insureds or are inadequate to ensure that all medical and health care services and items covered under the health insurance policy are provided in a manner ensuring availability of and accessibility to adequate personnel, specialty care, and facilities, the commissioner may order one or more sanctions under the authority of the commissioner in Insurance Code Chapters 82, concerning Sanctions, and 83, concerning Emergency Cease and Desist Orders, including:

(1) reduction of a service area;

(2) cessation of marketing in parts of the state; and

(3) cessation of marketing entirely and withdrawal from the preferred provider benefit plan market.

(b) This section does not affect the authority of the commissioner to order any other appropriate corrective action, sanction, or penalty under the authority of the commissioner in the Insurance Code in addition to or in lieu of the sanctions specified in subsection (a) of this section.

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