Texas Health Plan Network Adequacy Waiver Requests for Facility-Based Providers

Texas health insurers file waiver requests when their provider networks fail to meet state adequacy standards. The dataset contains waiver details for facility-based physicians and providers, published by the Texas Department of Insurance via data.texas.gov. Records include waiver status, decisions, and hearing dates.

Use Cases

• Analyze waiver approval rates by `County` and `Specialty type` to identify geographic or specialty-specific network gaps.
• Track `Waiver status` and `Waiver decision date` over time to monitor regulatory outcomes for specific `Insurer` networks.
• Correlate `Network adequacy status` with `Facility type` (e.g., Free Standing Emergency Room) to assess compliance challenges.
• Identify common `Reason preferred providers not available` cited in waiver requests to understand systemic provider shortages.

Strengths

• Includes 19 distinct columns covering waiver details, facility info, and regulatory status.
• Data is part of a structured series with related datasets for major medical and vision plans.

Limitations

• Sample data and total row count are unavailable, preventing assessment of dataset scale.
• Unknown license and author details limit clarity on reuse permissions.

Provenance

Source

Texas Department of Insurance (TDI), published via data.texas.gov.

Collection Method

Submitted by insurers as part of regulatory waiver request process.

Freshness

Last updated March 2026.

Geography

Texas, United States, with county-level granularity (`County`).