(a) A network must file a modification request with and receive approval from the department before the network makes a material modification to its network configuration. The modification request must be filed not later than 30 days prior to implementation of the material modification.
(b) A modification request for a modification to network configuration must include:
(1) a description and a map of the network's service area or areas, with key and scale, that identifies each county, ZIP code, partial ZIP code, or part of a county to be served as required by § 10.22 of this subchapter (relating to Contents of Application); and
(2) network configuration information, as required by § 10.22(11) of this subchapter.
(c) The applicant must file a copy of the form of any new contracts or amendment of any existing contracts as described by and required under § 10.22(3), (4) and (5) of this subchapter if the modification of network configuration causes changes.
(d) A modification request is not considered complete and reviewable until the department has received all information required under this section, including any additional information the department requests as needed to make the determination.
(e) Before the department considers a modification request to modify a network's configuration, the applicant must be in good standing with the department and in compliance with all applicable requirements under this chapter, Insurance Code Chapter 1305, and Labor Code Title 5.
(f) Prescribed modification request forms may be obtained from:
(1) the department's website at www.tdi.state.tx.us; or
(2) the HMO Division, Mail Code 103-6A, Texas Department of Insurance, P.O. Box 149104, Austin, Texas 78714-9104.
The provisions of this § 10.27 adopted to be effective December 5, 2005, 30 TexReg 8099.