{"@type": "dcat:Dataset", "accessLevel": "public", "contactPoint": {"@type": "vcard:Contact", "fn": "TDI ODP Administrator", "hasEmail": "mailto:no-reply@data.texas.gov"}, "description": "This dataset includes information related to network adequacy waiver requests filed by major medical health benefit plans. 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:\n   \n     \u2022\t<strong>Facility-based Physicians & Providers:</strong> <a href=\"https://data.texas.gov/dataset/Network-Adequacy-Waiver-Request-Facility-based-Phy/e597-cvix/about_data\"  target=\"_blank\"><u>Network Adequacy Waiver Request - Facility based Physicians & Providers</u></a>.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. \n\n     \u2022\t<strong>Vision: </strong><a href=\"https://data.texas.gov/dataset/Network-Adequacy-Waiver-Request-Vision/2zru-e4u3/about_data\"  target=\"_blank\"><u>Network Adequacy Waiver Request - Vision</u></a>. This dataset relates to waiver requests for networks used for vision PPO and EPO plans.\n\nInsurers 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. The commissioner of the Texas Department of Insurance (TDI) may grant the waiver following a public hearing and consideration of relevant testimony and information.\n\nAnyone may attend the public hearing and offer testimony. Learn more about how to submit information related to a waiver request or participate in a hearing here: <a href=\"https://www.tdi.texas.gov/hmo/mcqa/network-adequacy-standards-waivers.html\"  target=\"_blank\"><u>Network Adequacy Standards Waivers</u></a>.", "distribution": [{"@type": "dcat:Distribution", "describedBy": "https://data.austintexas.gov/api/views/yfeb-xw4b/columns.json", "describedByType": "application/json", "downloadURL": "https://data.austintexas.gov/api/views/yfeb-xw4b/rows.json?accessType=DOWNLOAD", "mediaType": "application/json"}, {"@type": "dcat:Distribution", "describedBy": "https://data.austintexas.gov/api/views/yfeb-xw4b/columns.rdf", "describedByType": "application/rdf+xml", "downloadURL": "https://data.austintexas.gov/api/views/yfeb-xw4b/rows.rdf?accessType=DOWNLOAD", "mediaType": "application/rdf+xml"}, {"@type": "dcat:Distribution", "describedBy": "https://data.austintexas.gov/api/views/yfeb-xw4b/columns.xml", "describedByType": "application/xml", "downloadURL": "https://data.austintexas.gov/api/views/yfeb-xw4b/rows.xml?accessType=DOWNLOAD", "mediaType": "application/xml"}, {"@type": "dcat:Distribution", "downloadURL": "https://data.austintexas.gov/api/views/yfeb-xw4b/rows.csv?accessType=DOWNLOAD", "mediaType": "text/csv"}], "identifier": "https://data.austintexas.gov/api/views/yfeb-xw4b", "issued": "2025-05-02", "keyword": ["access plan", "county", "date", "health", "hearing", "insurance", "network", "network adequacy", "ophthalmologist", "optometrist", "provider", "serff", "specialty", "status", "tdi", "waiver"], "landingPage": "https://data.austintexas.gov/d/yfeb-xw4b", "modified": "2026-04-29", "publisher": {"@type": "org:Organization", "name": "data.austintexas.gov"}, "title": "Network Adequacy Waiver Request - Major Medical"}