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The Texas Department of Insurance (TDI) has issued a bulletin on exclusive provider network (EPO) and health maintenance organization (HMO) responsibilities under recent federal legislation. The Families First Coronavirus Response Act and the CARES Act require certain insurers to cover COVID-19 testing and related office visits at no cost to the consumer.
In addition, TDI expects EPOs and HMOs to monitor and verify that their provider networks are adequate to handle increased demand and availability of testing and minimize the need for services outside the network. When a network provider is not reasonably available, carriers must ensure that the consumer is protected.
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