This bulletin is to advise carriers that the Texas Department of Insurance (Department) is temporarily suspending implementation of preferred provider benefit plan rule amendments until rules implementing recent legislation are adopted. This bulletin applies to amendments adopted on May 19, 2011, to 28 Texas Administrative Code Chapter 3, Subchapter X.
Several bills significantly affecting the Department's regulation of the managed care market were enacted this year, including HB 1772, 82nd Legislature, Regular Session, which amends the preferred provider plan chapter of the Insurance Code to allow insurers to offer exclusive provider benefit plans, and SB 7, 82nd Legislature, First Called Session, which permits preferred provider plan carriers to contract with health care collaboratives. Rules implementing these new managed care plans are necessary, and amendments of current rules will be required in order to align the rules and ensure consistency within the market.
During the rulemaking process, with the input of stakeholders, some requirements for preferred provider plans that were to be implemented by carriers by May 2012 could be modified. To prevent disruption of the market, the Department is providing notice through this bulletin that carriers will be granted additional time to implement the preferred provider plan requirements, and the Department will suspend enforcement of the new requirements until the revised rules are issued.
The Department intends to issue a draft rule and schedule a stakeholder meeting in the near future. Those interested in receiving information and participating in the rule development are encouraged to sign up for eNews updates on the Department's website at www.tdi.texas.gov/alert/emailnews.html.
If you have any specific questions regarding this bulletin, please contact Doug Danzeiser at 512-475-1964 or at Doug.Danzeiser@tdi.state.tx.us. For general information, please contact ChiefClerk@tdi.state.tx.us.
Eleanor Kitzman
Commissioner of Insurance