Network Adequacy Waiver Request - Major Medical

It includes data on physicians, providers, and facilities, other than facility-based physicians and providers. Related datasets are available for major medical (facility-based providers) and vision plans: • Facility-based Physicians & Providers: Network Adequacy Waiver Request - Facility based Physicians & Providers .This dataset relates to waiver requests for networks used for major medical PPO and EPO plans and includes data on facility-based physicians and providers. • Vision: Network Adequacy Waiver Request - Vision .

This dataset relates to waiver requests for networks used for vision PPO and EPO plans. Insurers offering health benefits through a preferred or exclusive provider benefit plan (also called PPO and EPO plans) are required to demonstrate that the health insurance network meets Texas network adequacy standards. When a network does not meet these requirements and has a deficiency in a county for a specific physician or provider specialty type, an insurer may apply for a waiver to continue operating within its service area.