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How do I file a Service Area Expansion/Reduction?

A Health Maintenance Organization (HMO) must submit a request for a service area expansion and/or a service area reduction for approval to the Texas Department of Insurance (TDI), Company Licensing and Registration Office. ( View the requirements here)

The HMO must ensure it has an adequate network in accordance with 28 TAC §11.1607. Once the list of contracted and credentialed providers is received the Managed Care Quality Assurance (MCQA) Office of TDI will request credentialing files for review.

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Last updated: 03/04/2015

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