Texas Health Plan Network Adequacy Waiver Requests

Texas Department of Insurance data on waiver requests from major medical health plans seeking exemptions from state network adequacy standards. It tracks insurer applications, hearing dates, and commissioner decisions for specific counties and provider specialties. The dataset is published by data.texas.gov and was last updated in March 2026.

Use Cases

• Analyze waiver approval rates by Insurer and County using Waiver status and Waiver decision date.
• Identify common Reason preferred providers not available for different Specialty types across counties.
• Track temporal trends in waiver requests using Waiver start date, Waiver end date, and Hearing date.
• Assess network coverage gaps by calculating the Percentage of insureds with sufficient choice per County and Specialty type.
• Monitor the regulatory process for specific plans using SERFF tracking No., Network ID, and Network adequacy status.

Strengths

• Contains 18 distinct columns detailing the regulatory process from application to decision.
• Explicitly linked to related datasets for facility-based providers and vision plans.

Limitations

• Sample data and row count are unavailable, preventing assessment of dataset size and representativeness.
• License information is unknown, which may restrict commercial or research use.
• Geographic scope is limited to Texas, limiting broader U.S. applicability.

Provenance

Source

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

Collection Method

Collected from mandatory waiver request filings by health insurers.

Time Range

null

Freshness

Last updated March 2026.

Geography

State of Texas, United States.