House Bill No. 3140 seeks to improve network adequacy standards for preferred provider benefit plans in Texas by amending Section 1301.0055 of the Insurance Code. The bill requires insurers to continuously monitor compliance with network adequacy standards and report significant deviations within 30 days, with corrective actions mandated within 90 days unless certain conditions are met. It introduces a requirement that at least 75% of insured individuals have access to a sufficient number of contracted healthcare providers and emergency services. Additionally, the bill modifies existing waiver provisions by removing limitations on waiver frequency and public hearing requirements, while emphasizing the need for disclosure of waiver information in promotional materials.

The bill also updates maximum travel times and distances for various medical specialties and healthcare settings, increasing allowances to enhance patient access to care, particularly in rural and underserved areas. It mandates that insurers undergo examinations of their plans and network adequacy at least once every three years, with documentation from these examinations being confidential. The bill repeals Sections 1301.00555 and 1301.00565 to streamline the regulatory process and specifies that the changes will apply to insurance policies delivered or renewed on or after January 1, 2026, with an effective date of 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)