(a) A health maintenance organization shall provide to its enrollees a list of providers, upon enrollment and re-enrollment.
(b) Every health maintenance organization shall provide to its enrollees within 30 days notice of any material change in the operation of the organization that will affect them directly.
(c) An enrollee must be notified in writing by a health maintenance organization of the termination of the primary care provider who provided health care services to that enrollee. A health maintenance organization shall provide assistance to the enrollee in transferring to another participating primary care provider.
(d) A health maintenance organization shall provide to enrollees information on how services may be obtained, where additional information on access to services can be obtained, and a number where the enrollee can contact the HMO at no cost to the enrollee.
(Apr. 9, 1997, D.C. Law 11-235, § 10, 44 DCR 818.)
1981 Ed., § 35-4509.
Structure District of Columbia Code
Title 31 - Insurance and Securities
Chapter 34 - Health Maintenance Organizations
§ 31–3402. Establishment of health maintenance organizations
§ 31–3403. Issuance of certificate of authority
§ 31–3404. Powers of health maintenance organizations
§ 31–3405. Fiduciary responsibilities
§ 31–3406. Quality assurance program
§ 31–3407. Requirements for group contract, individual contract, and evidence of coverage
§ 31–3408. Annual report. [Repealed]
§ 31–3408.01. Compliance with other laws
§ 31–3409. Information to enrollees
§ 31–3410. Grievance procedures [Repealed]
§ 31–3412. Protection against insolvency
§ 31–3413. Uncovered expenditures insolvency deposit
§ 31–3414. Enrollment period; replacement coverage in the event of insolvency
§ 31–3415. Filing requirements for rating information
§ 31–3416. Regulation of health maintenance organization producers
§ 31–3417. Powers of insurance corporations
§ 31–3418. Examinations. [Repealed]
§ 31–3419. Suspension or revocation of certificate of authority
§ 31–3420. Rehabilitation, liquidation, or conservation of health maintenance organizations
§ 31–3421. Summary orders and supervision
§ 31–3423. Penalties and enforcement
§ 31–3424. Statutory construction and relationship to other laws
§ 31–3425. Filings and reports as public documents
§ 31–3426. Confidentiality of medical information and limitation of liability
§ 31–3427. Acquisition of control of or merger of a health maintenance organization
§ 31–3428. Coordination of benefits. [Repealed]
§ 31–3429. Point of service plan