H.B. No. 3140 amends the Texas Insurance Code to strengthen network adequacy standards for preferred provider benefit plans. The bill requires insurers to continuously monitor compliance with these standards and report significant deviations to the department within 30 days. Insurers must take corrective actions within 90 days unless there are no uncontracted providers in the area or a waiver is requested. Additionally, the bill mandates that at least 75% of insured individuals have access to a sufficient number of contracted healthcare providers and emergency services within specified travel times and distances. It also modifies existing waiver provisions by removing the requirement for public testimony at hearings and allowing waivers to be granted for up to one year with good cause.

The bill further updates the maximum travel times and distances for various medical specialties and healthcare practitioners across different county classifications, enhancing access to care in areas with limited provider availability. It establishes a regulatory framework requiring insurers to undergo examinations of their benefit plans and network adequacy at least every three years, with documentation from these examinations being confidential. The bill also streamlines the regulatory process by repealing certain sections and updating reporting requirements to align with new provisions. These changes will apply to insurance policies delivered or renewed on or after January 1, 2026, with the bill taking effect on September 1, 2025.

Statutes affected:
Introduced: Insurance Code 1301.0055, Insurance Code 1301.00553, Insurance Code 1301.009, Insurance Code 1301.00555 (Insurance Code 1301)