This dataset includes information related to network adequacy waiver requests filed by major medical health benefit plans. It includes data on facility-based physicians and providers. Related datasets are available for major medical (non-facility-based providers) and vision plans:

• Major medical: Network Adequacy Waiver Request - Major Medical. This dataset relates to waiver requests for networks used for major medical PPO and EPO plans and includes data on physicians, providers, and facilities, other than facility-based physicians and providers.

• Vision: Network Adequacy Waiver Request - Vision. This dataset relates to waiver requests for networks used for vision PPO and EPO plans.

Insurers offering health benefits through a preferred or exclusive provider benefit plan (also called PPO and EPO plans) are required to demonstrate that the health insurance network meets Texas network adequacy standards. When a network does not meet these requirements and has a deficiency in a county for a specific physician or provider specialty type, an insurer may apply for a waiver to continue operating within its service area. The commissioner of the Texas Department of Insurance (TDI) may grant the waiver following a public hearing and consideration of relevant testimony and information.

Anyone may attend the public hearing and offer testimony. Learn more about how to submit information related to a waiver request or participate in a hearing here: Network Adequacy Standards Waivers.

This dataset includes information related to network adequacy waiver requests filed by vision plans. Related datasets are available for major medical PPO and EPO plans:

Major medical
•Network Adequacy Waiver Request - Facility based Physicians & Providers. This dataset relates to waiver requests for networks used for major medical PPO and EPO plans and includes data on facility-based physicians and providers.
• Network Adequacy Waiver Request - Major Medical. This dataset relates to waiver requests for networks used for major medical PPO and EPO plans and includes data on physicians, providers, and facilities, other than facility-based physicians and providers.

Insurers offering vision benefits through a preferred or exclusive provider benefit plan (also called PPO and EPO plans) are required to demonstrate that the health insurance network meets Texas network adequacy standards. When a network does not meet these requirements and has a deficiency in a county for a specific physician or provider specialty type, an insurer may apply for a waiver to continue operating within its service area. The commissioner of the Texas Department of Insurance (TDI) may grant the waiver following a public hearing and consideration of relevant testimony and information.

Anyone may attend the public hearing and offer testimony. Learn more about how to submit information related to a waiver request or participate in a hearing here: Network Adequacy Standards Waivers.

This dataset includes information related to network adequacy waiver requests filed by major medical health benefit plans. It includes data on physicians, providers, and facilities, other than facility-based physicians and providers. Related datasets are available for major medical (facility-based providers) and vision plans:

• Facility-based Physicians & Providers: Network Adequacy Waiver Request - Facility based Physicians & Providers.This dataset relates to waiver requests for networks used for major medical PPO and EPO plans and includes data on facility-based physicians and providers.

• Vision: Network Adequacy Waiver Request - Vision. This dataset relates to waiver requests for networks used for vision PPO and EPO plans.

Insurers offering health benefits through a preferred or exclusive provider benefit plan (also called PPO and EPO plans) are required to demonstrate that the health insurance network meets Texas network adequacy standards. When a network does not meet these requirements and has a deficiency in a county for a specific physician or provider specialty type, an insurer may apply for a waiver to continue operating within its service area. The commissioner of the Texas Department of Insurance (TDI) may grant the waiver following a public hearing and consideration of relevant testimony and information.

Anyone may attend the public hearing and offer testimony. Learn more about how to submit information related to a waiver request or participate in a hearing here: Network Adequacy Standards Waivers.