(a) Whenever the Commissioner determines that the financial condition of any health maintenance organization is such that its continued operation might be hazardous to its enrollees, creditors, or the general public, or that it has violated any provision of this chapter, the Commissioner may, after notice and hearing, order the health maintenance organization to take such action reasonably necessary to rectify the condition or violation, including, but not limited to, 1 or more of the following:
(1) Reduce the total amount of present and potential liability for benefits by reinsurance or other method acceptable to the Commissioner;
(2) Reduce the volume of new business being accepted;
(3) Reduce expenses by specified methods;
(4) Suspend or limit the writing of new business for a period of time;
(5) Increase the health maintenance organization’s capital and surplus by contribution; or
(6) Take such other steps as the Commissioner may deem appropriate under the circumstances.
(b) For the purposes of this section, a violation by a health maintenance organization of any law of the District to which the health maintenance organization is subject shall be deemed a violation of this chapter.
(c) The Commissioner is authorized, by rules and regulations, to set uniform standards and criteria for early warning that the continued operation of any health maintenance organization might be hazardous to its enrollees, creditors, or the general public and to set standards for evaluating the financial condition of any health maintenance organization, which standards shall be consistent with the purpose expressed in subsection (a) of this section.
(d) The remedies and measures available to the Commissioner under this section shall be in addition to, and not in lieu of, the remedies and measures available to the Commissioner under the provisions of Chapter 13 of this title.
(Apr. 9, 1997, D.C. Law 11-235, § 22, 44 DCR 818.)
1981 Ed., § 35-4521.
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 [Repealed]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