Dec 30, 2011

TDI Suspends PPO Rules

The Texas Department of Insurance (TDI) suspended preferred provider benefit regulations until it adopts rules implementing legislation passed in the 2011 session of the legislature. A bulletin from Insurance Commissioner Eleanor Kitzman said the legislature passed bills that significantly affect TDI's ability to regulate health care plans.

The rules that TDI suspended were the result of work by the TDI Network Adequacy Workgroup, which included facility-based physician members. The rules are the result of four years of work, beginning with the passage of Senate Bill 1731 in 2007, the study of network adequacy issues (as required by that bill), and the passage of House Bill 2256 in 2009. Since HB 2256 passed, TDI staff have worked with health plans, hospitals, and provider stakeholders to refine the rules, which were improved through the course of two informal and one formal postings, two public stakeholder meetings, and a public hearing.

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