tx-May82026-42: 28 TAC §11.1402 (Amendment) — Health Maintenance Organizations
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STATUTORY AUTHORITY. TDI proposes amendments to §11.1402 under Insurance Code §843.151 and §36.001. Insurance Code §843.151 authorizes the commissioner to adopt reasonable rules to implement various parts of the Insurance Code related to HMOs and ensure that enrollees have adequate access to health care services. Insurance Code §36.001 provides that the commissioner may adopt any rules necessary and appropriate to implement the powers and duties of TDI under the Insurance Code and other laws of this state. CROSS-REFERENCE TO STATUTE. The amendments to §11.1402 implement Insurance Code §843.305 and §1451.1545 as added by HB 3211. §11.1402. Notification to Physicians and Providers. (a) An HMO that provides coverage for health care services or medical care through one or more physicians or providers is required by Insurance Code §843.305, [(]concerning Annual Application Period for Physician and Providers to Contract,[)] to provide a 20-calendar day period each calendar year during which any provider or physician in the geographic service area may apply to participate in each of the HMO's networks providing health care services or medical care under the terms and conditions...
The agency’s own summary, as published.
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