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Section 27-41-1. - Short title. - § 27-41-1. Short title. This chapter may be cited as...
Section 27-41-2. - Definitions. - § 27-41-2. Definitions. As used in this chapter: (a) “Adverse...
Section 27-41-3. - Establishment of health maintenance organizations. - § 27-41-3. Establishment of health maintenance organizations. (a)(1) Notwithstanding chapter...
Section 27-41-4. - Issuance of license. - § 27-41-4. Issuance of license. (a)(1) Upon receipt of an...
Section 27-41-5. - Powers of health maintenance organizations. - § 27-41-5. Powers of health maintenance organizations. (a) The powers...
Section 27-41-6. - Governing body. - § 27-41-6. Governing body. (a) The governing body of any...
Section 27-41-7. - Fiduciary responsibilities. - § 27-41-7. Fiduciary responsibilities. (a) Any director, officer, or employee...
Section 27-41-8. - Evidence of coverage and charges for health care services. - § 27-41-8. Evidence of coverage and charges for health care...
Section 27-41-9. - Required reports. - § 27-41-9. Required reports. (a) Every health maintenance organization shall...
Section 27-41-10. - Information to enrollees. - § 27-41-10. Information to enrollees. Every health maintenance organization shall...
Section 27-41-11. - Complaint system. - § 27-41-11. Complaint system. (a) Every health maintenance organization shall...
Section 27-41-12. - Investments. - § 27-41-12. Investments. With the exception of investments made in...
Section 27-41-13. - Protection against insolvency. - § 27-41-13. Protection against insolvency. (a) Unless otherwise provided, each...
Section 27-41-13.1. - Initial net worth and capital requirements. - § 27-41-13.1. Initial net worth and capital requirements. (a) Before...
Section 27-41-13.2. - Ongoing net worth and capital requirements. - § 27-41-13.2. Ongoing net worth and capital requirements. (a) A...
Section 27-41-13.3. - Waiver, surplus notes, and risk based capital requirements. - § 27-41-13.3. Waiver, surplus notes, and risk based capital requirements....
Section 27-41-14. - Prohibited practices. - § 27-41-14. Prohibited practices. (a) No health maintenance organization, or...
Section 27-41-14.1. - Prohibition against restraint on provider — Patient communications. - § 27-41-14.1. Prohibition against restraint on provider — Patient communications....
Section 27-41-15. - Powers of insurers and hospital and medical service corporations. - § 27-41-15. Powers of insurers and hospital and medical service...
Section 27-41-16. - Examination. - § 27-41-16. Examination. (a) The director of business regulation may...
Section 27-41-17. - Suspension or revocation of license. - § 27-41-17. Suspension or revocation of license. (a) The director...
Section 27-41-18. - Rehabilitation, liquidation, or conservation of health maintenance organization. - § 27-41-18. Rehabilitation, liquidation, or conservation of health maintenance organization....
Section 27-41-18.1. - Summary orders and supervision. - § 27-41-18.1. Summary orders and supervision. (a) Whenever the director...
Section 27-41-19. - Rules and regulations. - § 27-41-19. Rules and regulations. The director of business regulation...
Section 27-41-20. - Administrative procedures. - § 27-41-20. Administrative procedures. (a) When the director of business...
Section 27-41-21. - Penalties and enforcement. - § 27-41-21. Penalties and enforcement. (a) The director of business...
Section 27-41-22. - Statutory construction and relationship to other laws. - § 27-41-22. Statutory construction and relationship to other laws. (a)...
Section 27-41-23. - Filings and reports as public documents. - § 27-41-23. Filings and reports as public documents. The provisions...
Section 27-41-24. - Director of health’s authority to contract. - § 27-41-24. Director of health’s authority to contract. The director...
Section 27-41-25. - Holding company systems. - § 27-41-25. Holding company systems. Except to the extent superseded...
Section 27-41-26. - Enrollee liability. - § 27-41-26. Enrollee liability. No enrollee is liable to any...
Section 27-41-26.1. - Patient responsibility — Administrative requirements. - § 27-41-26.1. Patient responsibility — Administrative requirements. For health benefit...
Section 27-41-27. - Offer of health maintenance organization alternative to employees. - § 27-41-27. Offer of health maintenance organization alternative to employees....
Section 27-41-27.1. - No derogation of attorney general. - § 27-41-27.1. No derogation of attorney general. No provision of...
Section 27-41-27.2. - Health insurance rates. - § 27-41-27.2. Health insurance rates. No insurance company organized as...
Section 27-41-28. - Applicability. - § 27-41-28. Applicability. Notwithstanding any of the provisions of this...
Section 27-41-29. - Severability. - § 27-41-29. Severability. If any section, term, or provision of...
Section 27-41-29.1. - Uniform explanation of benefits and coverage. - § 27-41-29.1. Uniform explanation of benefits and coverage. (a) A...
Section 27-41-29.2. - Filing of policy forms. - § 27-41-29.2. Filing of policy forms. (a) A health maintenance...
Section 27-41-30. - Mammograms and pap smears — Coverage mandated. - § 27-41-30. Mammograms and pap smears — Coverage mandated. (a)...
Section 27-41-30.1. - Post-partum hospital stays. - § 27-41-30.1. Post-partum hospital stays. (a) Every individual or group...
Section 27-41-31. - Mammograms — Quality assurance standards. - § 27-41-31. Mammograms — Quality assurance standards. A mammogram eligible...
Section 27-41-32. - Pap smears — Quality assurance standards. - § 27-41-32. Pap smears — Quality assurance standards. A pap...
Section 27-41-33. - Coverage for infertility. - § 27-41-33. Coverage for infertility. (a) Any health maintenance organization...
Section 27-41-34. - Health maintenance organizations’ assessment. - § 27-41-34. Health maintenance organizations’ assessment. (a) Notwithstanding any other...
Section 27-41-35. - Enrollment period in the event of insolvency. - § 27-41-35. Enrollment period in the event of insolvency. (a)...
Section 27-41-36. - Services of midwives. - § 27-41-36. Services of midwives. Every health maintenance organization plan...
Section 27-41-37. - Discontinuance of coverage — Chronic disabilities. - § 27-41-37. Discontinuance of coverage — Chronic disabilities. No health...
Section 27-41-38. - Drug coverage. - § 27-41-38. Drug coverage. No health maintenance organization that provides...
Section 27-41-38.1. - Medication synchronization. - § 27-41-38.1. Medication synchronization. (a) An individual or group health...
Section 27-41-38.2. - Pharmacy benefit manager requirements with respect to multi-source generic pricing updates to pharmacies. - § 27-41-38.2. Pharmacy benefit manager requirements with respect to multi-source...
Section 27-41-39. - Certified registered nurse practitioners and psychiatric and mental health nurse clinical specialists. - § 27-41-39. Certified registered nurse practitioners and psychiatric and mental...
Section 27-41-40. - Certified counselors in mental health and therapists in marriage and family practice. - § 27-41-40. Certified counselors in mental health and therapists in...
Section 27-41-41. - Repealed. - § 27-41-41. Repealed. History of Section.P.L. 1994, ch. 301, §...
Section 27-41-41.1. - Repealed. - § 27-41-41.1. Repealed. History of Section.P.L. 1994, ch. 301, §...
Section 27-41-41.2. - Repealed. - § 27-41-41.2. Repealed. History of Section.P.L. 1994, ch. 301, §...
Section 27-41-41.3. - Repealed. - § 27-41-41.3. Repealed. History of Section.P.L. 1994, ch. 301, §...
Section 27-41-42. - Repealed. - § 27-41-42. Repealed.
Section 27-41-43. - Mastectomy treatment. - § 27-41-43. Mastectomy treatment. (a) All individual or group health...
Section 27-41-43.1. - Insurance coverage for mastectomy hospital stays. - § 27-41-43.1. Insurance coverage for mastectomy hospital stays. (a) The...
Section 27-41-44. - Diabetes treatment. - § 27-41-44. Diabetes treatment. (a) Every individual or group health...
Section 27-41-45. - Primary and preventive obstetric and gynecological care. - § 27-41-45. Primary and preventive obstetric and gynecological care. Any...
Section 27-41-45.1. - Hysterectomy or myomectomy treatment. - § 27-41-45.1. Hysterectomy or myomectomy treatment. Commencing January 1, 2023,...
Section 27-41-46. - Whistleblowers protection. - § 27-41-46. Whistleblowers protection. No health maintenance organizations pursuant to...
Section 27-41-47. - Penalties and remedies. - § 27-41-47. Penalties and remedies. (a) Any person, firm, corporation,...
Section 27-41-48. - Additional relief and damages — Reinstatement. - § 27-41-48. Additional relief and damages — Reinstatement. (a) A...
Section 27-41-49. - Third-party reimbursement for services of certain healthcare workers. - § 27-41-49. Third-party reimbursement for services of certain healthcare workers....
Section 27-41-49.1. - Third party reimbursement for services of registered nurse first assistants. - § 27-41-49.1. Third party reimbursement for services of registered nurse...
Section 27-41-50. - Human leukocyte antigen testing. - § 27-41-50. Human leukocyte antigen testing. Every individual or group...
Section 27-41-51. - Drug coverage. - § 27-41-51. Drug coverage. (a) Any health maintenance organization that...
Section 27-41-52. - Restricted annual rate payments prohibited. - § 27-41-52. Restricted annual rate payments prohibited. (a) No corporation...
Section 27-41-53. - Genetic testing. - § 27-41-53. Genetic testing. (a) Except as provided in chapter...
Section 27-41-53.1. - Genetic information. - § 27-41-53.1. Genetic information. (a) Except as provided in chapter...
Section 27-41-54. - Disassociation prohibited. - § 27-41-54. Disassociation prohibited. Notwithstanding any provision of the general...
Section 27-41-55. - Repealed. - § 27-41-55. Repealed.
Section 27-41-56. - Magnetic resonance imaging — Quality assurance standards. - § 27-41-56. Magnetic resonance imaging — Quality assurance standards. (a)...
Section 27-41-57. - Acupuncture services. - § 27-41-57. Acupuncture services. (a) Every group health insurance contract,...
Section 27-41-58. - Prohibition against requiring indemnification from dentists. - § 27-41-58. Prohibition against requiring indemnification from dentists. No contract...
Section 27-41-59. - F.D.A. approved prescription contraceptive drugs and devices. - § 27-41-59. F.D.A. approved prescription contraceptive drugs and devices. (a)...
Section 27-41-60. - Prostate and colorectal examinations — Coverage mandated — The Maryellen Goodwin Colorectal Cancer Screening Act. - § 27-41-60. Prostate and colorectal examinations — Coverage mandated —...
Section 27-41-61. - Eligibility for children’s benefits. - § 27-41-61. Eligibility for children’s benefits. (a)(1) Every health benefit...
Section 27-41-62. - Temporary credentials. - § 27-41-62. Temporary credentials. Notwithstanding any requirements of any health...
Section 27-41-63. - Hearing aids. - § 27-41-63. Hearing aids. (a)(1) Every individual or group health...
Section 27-41-64. - Prompt processing of claims. - § 27-41-64. Prompt processing of claims. (a) A health care...
Section 27-41-65. - Mandatory coverage for certain lyme disease treatments. - § 27-41-65. Mandatory coverage for certain lyme disease treatments. Subscribers...
Section 27-41-66. - Dental insurance assignment of benefits. - § 27-41-66. Dental insurance assignment of benefits. Every entity licensed...
Section 27-41-67. - Determination of maximum coverage limitation for prescription drug benefits. - § 27-41-67. Determination of maximum coverage limitation for prescription drug...
Section 27-41-68. - Coverage for early intervention services. - § 27-41-68. Coverage for early intervention services. (a) Every individual...
Section 27-41-69. - Post-payment audits. - § 27-41-69. Post-payment audits. (a) Except as otherwise provided herein,...
Section 27-41-70. - Tobacco cessation programs. - § 27-41-70. Tobacco cessation programs. (a) Every individual or group...
Section 27-41-71. - Mandatory coverage for scalp hair prosthesis. - § 27-41-71. Mandatory coverage for scalp hair prosthesis. (a) Every...
Section 27-41-72. - Reimbursement for orthotic and prosthetic services. - § 27-41-72. Reimbursement for orthotic and prosthetic services. (a) As...
Section 27-41-73. - Licensed ambulance service. - § 27-41-73. Licensed ambulance service. (a) No individual or group...
Section 27-41-74. - Enteral nutrition products. - § 27-41-74. Enteral nutrition products. (a) Every individual or group...
Section 27-41-75. - Prohibition on rescission of coverage. - § 27-41-75. Prohibition on rescission of coverage. (a)(1) Coverage under...
Section 27-41-76. - Prohibition on annual and lifetime limits. - § 27-41-76. Prohibition on annual and lifetime limits. (a) Annual...
Section 27-41-77. - Coverage for individual participating in approved clinical trials. - § 27-41-77. Coverage for individual participating in approved clinical trials....
Section 27-41-78. - Medical loss ratio reporting and rebates. - § 27-41-78. Medical loss ratio reporting and rebates. (a) A...
Section 27-41-79. - Emergency services. - § 27-41-79. Emergency services. (a) As used in this section:...
Section 27-41-80. - Internal and external appeal of adverse benefit determinations. - § 27-41-80. Internal and external appeal of adverse benefit determinations....
Section 27-41-81. - Prohibition on preexisting condition exclusions. - § 27-41-81. Prohibition on preexisting condition exclusions. (a) A health...
Section 27-41-82. - Primary care provider designation requirement. - § 27-41-82. Primary care provider designation requirement. Every individual or...
Section 27-41-83. - Discretionary clauses. - § 27-41-83. Discretionary clauses. (a) No new or existing policy...
Section 27-41-84. - Orally administered anticancer medication — Cost-sharing requirement. - § 27-41-84. Orally administered anticancer medication — Cost-sharing requirement. (a)...
Section 27-41-85. - Consumer notification. - § 27-41-85. Consumer notification. Every health maintenance organization providing dental...
Section 27-41-86. - Opioid antagonists. - § 27-41-86. Opioid antagonists. (a) Every individual or group health...
Section 27-41-87. - Healthcare provider credentialing. - § 27-41-87. Healthcare provider credentialing. (a) For applications received on...
Section 27-41-88. - Unfair discrimination prohibited. - § 27-41-88. Unfair discrimination prohibited. Notwithstanding any provision of any...
Section 27-41-89. - Health insurance contracts — Full year coverage for contraception. - § 27-41-89. Health insurance contracts — Full year coverage for...
Section 27-41-90. - Prohibition on discrimination in organ transplants. - § 27-41-90. Prohibition on discrimination in organ transplants. Pursuant to...
Section 27-41-91. - Health insurance contracts — Copayments exemption for COVID-19 vaccinations. - § 27-41-91. Health insurance contracts — Copayments exemption for COVID-19...
Section 27-41-92. - Perinatal doulas. - § 27-41-92. Perinatal doulas. (a) As used in this section,...
Section 27-41-93. - Gender rating. [Effective January 1, 2023.] - § 27-41-93. Gender rating. [Effective January 1, 2023.] (a) No...
Section 27-41-94. - Coverage for biomarker testing. - § 27-41-94. Coverage for biomarker testing. (a) As used in...
Section 27-41-95. - Mandatory coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome. [Expires December 31, 2025.] - § 27-41-95. Mandatory coverage for treatment of pediatric autoimmune neuropsychiatric...