Suspension of duplicate network adequacy reviews for CHIP and Medicaid networks

Home Bulletins Commissioner bulletins – 2020 B-0031-20 June 25, 2020 To:   Insurance companies and health maintenance organizations Re:   Suspension of duplicate network adequacy reviews for CHIP and Medicaid networks This bulletin advises insurance companies and health maintenance organizations (HMOs) contracting with CHIP and Medicaid for provider networks that the Texas Department of Insurance (TDI) is temporarily suspending duplicate reviews of those networks. Provider networks for CHIP and Medicaid programs are reviewed and examined by both Texas Health and Human Services Commission and the U.S. Department of Health and Human Services. TDI is considering rule changes to eliminate duplicative processes for network adequacy review and approval, and to reduce the administrative burden on insurers and HMOs that provide these networks. While rule amendments are being considered, TDI will suspend enforcement of 28 Texas Administrative Code Sections 11.1607, 11.1610, and 3.3709 as they apply to those insurance companies' and HMOs' accessibility and availability requirements and annual network adequacy reports. For questions about this bulletin, contact the MCQA Office at MCQA@tdi.texas.gov . For more information, contact: MCQA@tdi.texas.gov Last updated: 6/25/2020