- Home
- Advocacy
- Latest News and Practice Data
- Texas Governor Enacts Network Adequacy Law Supported by TSP, CAP
On June 12, Texas Gov. Greg Abbott signed into law health plan network adequacy legislation (House Bill 3359) supported by the Texas Society of Pathologists (TSP) and the CAP, working with the Texas Medical Association. The new law requires preferred provider organization health plans to meet state requirements so that their enrollees can access in-network physician services, including pathology and laboratory services, at in-network facilities and geographically accessible services within the network based upon time and distance standards as expressly prescribed.
For in-network facilities, the new law will “require a sufficient number of preferred providers of emergency medicine, anesthesiology, pathology, radiology, neonatology, oncology, including medical, surgical, and radiation oncology, surgery, and hospitalist, intensivist, and diagnostic services, including radiology and laboratory services, at each preferred hospital, ambulatory surgical center, or freestanding emergency medical care facility...”
The insurance commissioner will be required to develop rules to review a preferred provider benefit plan before it is offered to insureds to ensure the plan’s provider network meets the quality of care and network adequacy standards. With the enactment of this law, Texas became the third state this year (in addition to Tennessee and Georgia) to enact a health plan network adequacy statutory requirement that includes clinical laboratory and pathology services. The law takes effect September 1, 2023.