(A) When the director or his designee 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 thirty days thereafter for a hearing on the matter. However, if the ground for suspension or revocation relates solely to financial condition, the director or his designee may immediately and without hearing suspend the certificate of authority of the health maintenance organization.
(B) The provisions of Article 3, Chapter 23, Title 1, apply to administrative proceedings under this section. Whenever the director or his designee issues an order of suspension without an administrative hearing before the director or his designee based upon a health maintenance organization's financial condition, as authorized under subsection (A), the health maintenance organization has a right to judicial review before the Administrative Law Court in accordance with law.
HISTORY: Enacted as 1976 Code Section 38-25-210 by 1987 Act No. 83, Section 1; recodified as Section 38-33-210 by 1987 Act No. 155, Section 24; 1993 Act No. 181, Section 633.
Structure South Carolina Code of Laws
Chapter 33 - Health Maintenance Organizations
Section 38-33-10. Short title.
Section 38-33-20. Definitions.
Section 38-33-30. Necessity of certificate of authority; foreign corporation.
Section 38-33-50. Powers of health maintenance organization; notice prior to exercise of powers.
Section 38-33-60. Members of governing body; advisory panels, etc.
Section 38-33-70. Fiduciary relationship in handling of funds.
Section 38-33-90. Statements and reports.
Section 38-33-120. Investment of funds.
Section 38-33-150. Agent for organization; exemption from licensing requirements.
Section 38-33-180. Suspension or revocation of certificate of authority.
Section 38-33-200. Implementation of regulations.
Section 38-33-250. Records of organization as public documents; trade secrets, etc.
Section 38-33-260. Confidentiality of health records.
Section 38-33-300. Liability for participation in quality of care or utilization review.
Section 38-33-310. HMO may contract with out-of-state provider.