41-3911. EXAMINATIONS. (1) The director shall make an examination of the affairs and operations of any organization offering a managed care plan for which a certificate of authority is required as often as he deems necessary but not less frequently than once every five (5) years.
(2) Every such organization shall upon the director’s request submit its books and records relating to its affairs and operations to such examination and shall facilitate the examination.
(3) Health records of individuals and records of providers providing services under a contract with the managed care organization shall not be subject to such examination, except as provided in section 41-3909(3), Idaho Code.
(4) At the direction of the director, the expenses of examination shall be borne by the organization being examined in accordance with section 41-228, Idaho Code.
History:
[41-3911, added 1974, ch. 177, sec. 11, p. 1444; am. 1997, ch. 204, sec. 12, p. 589; am. 2001, ch. 85, sec. 11, p. 219.]
Structure Idaho Code
Chapter 39 - MANAGED CARE REFORM
Section 41-3901 - SHORT TITLE.
Section 41-3902 - INTENT AND PURPOSE.
Section 41-3903 - DEFINITIONS.
Section 41-3905 - QUALIFICATIONS FOR CERTIFICATE OF AUTHORITY.
Section 41-3906 - APPLICATION FOR CERTIFICATE OF AUTHORITY.
Section 41-3910 - REPORTS TO THE DIRECTOR.
Section 41-3911 - EXAMINATIONS.
Section 41-3912 - SUSPENSION OR REVOCATION OF CERTIFICATE OF AUTHORITY.
Section 41-3914 - ANNUAL DISCLOSURES.
Section 41-3915 - HEALTH CARE CONTRACTS.
Section 41-3916 - ADVISORY PANELS.
Section 41-3917 - CERTAIN WORDS PROHIBITED IN NAME OF ORGANIZATION.
Section 41-3918 - GRIEVANCE SYSTEM.
Section 41-3919 - OPEN ENROLLMENT.
Section 41-3921 - STATUTORY CONSTRUCTION AND RELATIONSHIP TO OTHER LAWS.
Section 41-3922 - TAXATION — PENALTY FOR FAILURE TO FILE.
Section 41-3924 - LIMITATION OF BENEFITS FOR ELECTIVE ABORTIONS.
Section 41-3925 - SERVICES PROVIDED BY GOVERNMENTAL ENTITIES.
Section 41-3926 - MAMMOGRAPHY COVERAGE.
Section 41-3928 - INCENTIVES TO WITHHOLD CARE PROHIBITED.
Section 41-3930 - UTILIZATION MANAGEMENT PROGRAM REQUIREMENTS.
Section 41-3931 - PARTICIPATION IN IDAHO LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION.