On October 8, 2018, the Texas Department of Insurance fined Humana $700,000 and issued Consent Orders against Humana for failing to include an adequate number of anesthesiologists in three of the state’s largest metropolitan areas (Houston, San Antonio, and Austin).   The Texas Department of Insurance contends that Humana’s actions put consumers at risk of receiving balance bills. 

Texas requires that health plans file annual network adequacy reports with the Texas Department of Insurance and notify the agency of any gaps in the network.  Humana, Texas’s fourth largest health insurance writer, allegedly submitted reports to the Texas Department of Insurance that included providers no longer in its networks and did not adequately or timely disclose network adequacy issues to the Texas Department of Insurance or consumers.   In connection with the agreement reached with the Texas Department of Insurance, Humana has agreed to process all impacted claims as in-network claims. 

To view the Texas Department of Insurance’s announcement and copies of the Consent Orders, click here.