RCW 48.46.120
Examination of health maintenance organizations—Duties of organizations, powers of commissioner—Independent audit reports.
(1) The commissioner may make an examination of the operations of any health maintenance organization as often as he or she deems necessary in order to carry out the purposes of this chapter.
(2) Every health maintenance organization shall submit its books and records relating its operation for financial condition and market conduct examinations and in every way facilitate them. The quality or appropriateness of medical services or systems shall not be examined except to the extent that such items are incidental to an examination of the financial condition or the market conduct of a health maintenance organization. For the purpose of examinations, the commissioner may issue subpoenas, administer oaths, and examine the officers and principals of the health maintenance organization and the principals of such providers concerning their business.
(3) The commissioner may elect to accept and rely on audit reports made by an independent certified public accountant for the health maintenance organization in the course of that part of the commissioner's examination covering the same general subject matter as the audit. The commissioner may incorporate the audit report in his or her report of the examination.
[ 2009 c 549 § 7152; 2007 c 468 § 2; 1987 c 83 § 1; 1986 c 296 § 9; 1985 c 7 § 115; 1983 c 63 § 2; 1975 1st ex.s. c 290 § 13.]
NOTES:
Severability—Effective date—1986 c 296: See notes following RCW 48.14.020.
Structure Revised Code of Washington
Chapter 48.46 - Health Maintenance Organizations.
48.46.010 - Legislative declaration—Purpose.
48.46.012 - Filings with secretary of state—Copy for commissioner.
48.46.027 - Registration, required—Issuance of securities—Penalty.
48.46.033 - Unregistered activities—Acts committed in this state—Sanctions.
48.46.045 - Catastrophic health plans permitted.
48.46.062 - Schedule of rates for individual agreements—Loss ratio—Definitions.
48.46.064 - Calculation of premiums—Adjusted community rate—Definitions.
48.46.068 - Requirements for plans offered to small employers—Definitions.
48.46.080 - Annual statement—Filings—Contents—Fee—Penalty for failure to file—Accuracy required.
48.46.090 - Standard of services provided.
48.46.100 - Grievance procedure.
48.46.135 - Fine in addition to or in lieu of suspension, revocation, or refusal.
48.46.170 - Effect of chapter as to other laws—Construction.
48.46.190 - Payroll deductions for capitation payments to health maintenance organizations.
48.46.200 - Rules and regulations.
48.46.210 - Compliance with federal funding requirements—Construction.
48.46.220 - Review of administrative action.
48.46.225 - Financial failure—Supervision of commissioner—Priority of distribution of assets.
48.46.235 - Minimum net worth—Requirement to maintain—Determination of amount.
48.46.237 - Minimum net worth—Domestic or foreign health maintenance organization.
48.46.240 - Funded reserve requirements.
48.46.243 - Contract—Participant liability.
48.46.245 - Plan for handling insolvency—Commissioner's review.
48.46.247 - Insolvency—Commissioner's duties—Participants' options—Allocation of coverage.
48.46.272 - Diabetes coverage—Definitions.
48.46.274 - Prescribed, self-administered anticancer medication.
48.46.275 - Mammograms—Insurance coverage.
48.46.277 - Prostate cancer screening.
48.46.280 - Reconstructive breast surgery.
48.46.285 - Mastectomy, lumpectomy.
48.46.291 - Mental health services—Health plans—Definition—Coverage required, when.
48.46.292 - Mental health treatment—Waiver of preauthorization for persons involuntarily committed.
48.46.300 - Future dividends or refunds, restricted—Issuance or sale of securities regulated.
48.46.310 - Registration not endorsement.
48.46.320 - Dependent children, termination of coverage, conditions.
48.46.325 - Option to cover child under age twenty-six.
48.46.340 - Return of agreement within ten days.
48.46.350 - Chemical dependency treatment.
48.46.355 - "Chemical dependency" defined.
48.46.370 - Coverage not denied for disability.
48.46.380 - Notice of reason for cancellation, denial, or refusal to renew agreement.
48.46.400 - False or misleading advertising prohibited.
48.46.410 - Misrepresentations to induce termination or retention of agreement prohibited.
48.46.420 - Penalty for violations.
48.46.430 - Enforcement authority of commissioner.
48.46.440 - Continuation option to be offered.
48.46.450 - Conversion agreement to be offered—Exceptions, conditions.
48.46.460 - Conversion agreement—Restrictions and requirements—Rules.
48.46.470 - Endorsement of modifications.
48.46.480 - Continuation of coverage of former family members.
48.46.490 - Coverage for adopted children.
48.46.500 - Cancellation of rider.
48.46.520 - Neurodevelopmental therapies—Employer-sponsored group contracts.
48.46.530 - Temporomandibular joint disorders—Insurance coverage.
48.46.540 - Nonresident pharmacies.
48.46.565 - Foot care services.
48.46.570 - Denturist services.
48.46.580 - When injury caused by intoxication or use of narcotics.
48.46.600 - Disclosure of certain material transactions—Report—Information is confidential.
48.46.605 - Material acquisitions or dispositions.
48.46.610 - Asset acquisitions—Asset dispositions.
48.46.615 - Report of a material acquisition or disposition of assets—Information required.
48.46.620 - Material nonrenewals, cancellations, or revisions of ceded reinsurance agreements.
48.46.900 - Liberal construction.
48.46.930 - Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.