58-67-155. Administrative procedures.
(a) When the Commissioner has cause to believe that grounds for the denial of an application for a certificate of authority exist, or that grounds for the suspension or revocation of a certificate of authority exist, he shall notify the health maintenance organization in writing specifically stating the grounds for denial, suspension, or revocation and fixing a time of at least 30 days thereafter for a hearing on the matter.
(b) After such hearing, or upon the failure of the health maintenance organization to appear at such hearing, the Commissioner shall take action as is deemed advisable or written findings which shall be mailed to the health maintenance organization. The action of the Commissioner shall be subject to review by the Superior Court of Wake County. The court may, in disposing of the issue before it, modify, affirm, or reverse the order of the Commissioner in whole or in part.
(c) The provisions of Chapter 150B of the General Statutes of this State shall apply to proceedings under this section to the extent that they are not in conflict with subsections (a) and (b). (1977, c. 580, s. 1; 1979, c. 876, s. 1; 1987, c. 827, s. 1.)
Structure North Carolina General Statutes
North Carolina General Statutes
Article 67 - Health Maintenance Organization Act.
§ 58-67-10 - Establishment of health maintenance organizations.
§ 58-67-11 - Additional HMO application information.
§ 58-67-12 - Commissioner use of consultants and other professionals.
§ 58-67-20 - Issuance and continuation of license.
§ 58-67-30 - Management and exclusive agreements; custodial agreements.
§ 58-67-35 - Powers of health maintenance organizations.
§ 58-67-45 - Fiduciary responsibilities.
§ 58-67-50 - Evidence of coverage and premiums for health care services.
§ 58-67-55 - Statements filed with Commissioner.
§ 58-67-65 - Prohibited practices.
§ 58-67-66 - Collaboration with local health departments.
§ 58-67-70 - Coverage for chemical dependency treatment.
§ 58-67-74 - Coverage for certain treatment of diabetes.
§ 58-67-75 - No discrimination against mentally ill or chemically dependent individuals.
§ 58-67-76 - Coverage for mammograms and cervical cancer screening.
§ 58-67-77 - Coverage for prostate-specific antigen (PSA) tests.
§ 58-67-78 - Coverage of certain prescribed drugs for cancer treatment.
§ 58-67-79 - Coverage for reconstructive breast surgery following mastectomy.
§ 58-67-80 - Meaning of terms "accident", "accidental injury", and "accidental means".
§ 58-67-85 - Master group contracts, filing requirement; required and prohibited provisions.
§ 58-67-88 - Continuity of care.
§ 58-67-90 - Licensing and regulation of agents.
§ 58-67-95 - Powers of insurers, hospitals, prepaid health plans, and medical service corporations.
§ 58-67-105 - Hazardous financial condition.
§ 58-67-110 - Protection against insolvency.
§ 58-67-115 - Hold harmless agreements or special deposit.
§ 58-67-120 - Continuation of benefits.
§ 58-67-125 - Enrollment period.
§ 58-67-130 - Replacement coverage.
§ 58-67-135 - Incurred but not reported claims.
§ 58-67-140 - Suspension or revocation of license.
§ 58-67-145 - Rehabilitation, liquidation, or conservation of health maintenance organization.
§ 58-67-155 - Administrative procedures.
§ 58-67-165 - Penalties and enforcement.
§ 58-67-170 - Statutory construction and relationship to other laws.
§ 58-67-171 - Other laws applicable to HMOs.
§ 58-67-175 - Filings and reports as public documents.