| (a) If the commissioner determines, after notice and
opportunity for hearing, that the insurer's network and any access
plan supporting the network are inadequate to ensure that preferred
provider benefits are reasonably available to all insureds or are
inadequate to ensure that all medical and health care services and
items covered under the health insurance policy are provided in a
manner ensuring availability of and accessibility to adequate personnel,
specialty care, and facilities, the commissioner may order one or
more sanctions under the authority of the commissioner in Insurance
Code Chapters 82, concerning Sanctions, and 83, concerning Emergency
Cease and Desist Orders, including:
(1) reduction of a service area;
(2) cessation of marketing in parts of the state; and
(3) cessation of marketing entirely and withdrawal
from the preferred provider benefit plan market.
(b) This section does not affect the authority of the
commissioner to order any other appropriate corrective action, sanction,
or penalty under the authority of the commissioner in the Insurance
Code in addition to or in lieu of the sanctions specified in subsection
(a) of this section.
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| Source Note: The provisions of this §3.3710 adopted to be effective December 6, 2011, 36 TexReg 3411; amended to be effective February 21, 2013, 38 TexReg 827; amended to be effective April 25, 2024, 49 TexReg 2497 |
