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Section 38-33-10. Short title. - This chapter may be cited as the Health Maintenance Organization...
Section 38-33-20. Definitions. - As used in this chapter: (1) "Basic health care services"...
Section 38-33-30. Necessity of certificate of authority; foreign corporation. - (A) No person may establish or operate a health maintenance...
Section 38-33-40. Issuance of certificate of authority; criteria and considerations; arrangements for participation of providers in each geographic area served. - (A) The director or his designee shall issue a certificate...
Section 38-33-50. Powers of health maintenance organization; notice prior to exercise of powers. - (A) The powers of a health maintenance organization include, but...
Section 38-33-60. Members of governing body; advisory panels, etc. - (A) The governing body of any health maintenance organization may...
Section 38-33-70. Fiduciary relationship in handling of funds. - Any director, officer, employee, or partner of a health maintenance...
Section 38-33-80. Enrollee entitled to evidence of coverage; contents of evidence of coverage; discontinuance or replacement of coverage; charges for services. - (A)(1) Every enrollee is entitled to an evidence of coverage...
Section 38-33-90. Statements and reports. - (A) Every health maintenance organization annually shall file with the...
Section 38-33-100. Financial requirements before issuance of certificate of authority to health maintenance organization. - (A) No health maintenance organization may be issued a certificate...
Section 38-33-110. Complaint procedures; reports; malpractice claims; applicability of Freedom of Information Act. - (A)(1) Every health maintenance organization shall establish and maintain a...
Section 38-33-120. Investment of funds. - With the exception of investments made in accordance with Section...
Section 38-33-130. Security deposit; individual stop-loss coverage; provisions for unpaid claim liability; individual conversion policy. - (A) Each health maintenance organization shall deposit and maintain with...
Section 38-33-140. Advertisements; application of provisions relating to trade practices; use of term "insurer" or "health maintenance organization". - (A) No health maintenance organization, or representative thereof, may cause...
Section 38-33-150. Agent for organization; exemption from licensing requirements. - (A) An agent means a person who is appointed or...
Section 38-33-160. Operation of health maintenance organization by insurance company; contracts for cost of care. - (A) An insurance company licensed in this State may through...
Section 38-33-170. Examination of affairs of organization; quality of health care services; books and records; expense of examination; reports. - (A) The director or his designee may make an examination...
Section 38-33-180. Suspension or revocation of certificate of authority. - (A) The director or his designee may suspend or revoke...
Section 38-33-190. Rehabilitation, liquidation, or conservation of a health maintenance organization; priorities. - Any rehabilitation, liquidation, or conservation of a health maintenance organization...
Section 38-33-200. Implementation of regulations. - The department may, after notice and hearing, promulgate regulations to...
Section 38-33-210. Notification of grounds for denial, suspension or revocation of certificate of authority; hearings; judicial review. - (A) When the director or his designee has cause to...
Section 38-33-220. Fees. - (A) Every health maintenance organization subject to this chapter shall...
Section 38-33-230. Levy of administrative penalty in lieu of revocation or suspension of certificate of authority; monetary penalty; notice and hearings; injunctions. - (A) The director or his designee, in lieu of revocation...
Section 38-33-240. Application of provisions of insurance law or law relating to solicitation or advertising by health professionals; practice of medicine, dentistry or other healing profession. - (A) Except as otherwise specifically provided, the provisions of the...
Section 38-33-250. Records of organization as public documents; trade secrets, etc. - All applications and filings required under Section 38-33-30 and any...
Section 38-33-260. Confidentiality of health records. - Any data or information pertaining to the diagnosis, treatment, or...
Section 38-33-270. Contractual powers of Department to assist in investigative duties; assessments for consulting expenses. - (A) The director or his designee, in carrying out the...
Section 38-33-280. Acquisition or exchange of securities of a health maintenance organization; merger or consolidation of HMO. - (A) No person may make a tender for or a...
Section 38-33-290. Participation by physician, podiatrist, optometrist, or oral surgeon as provided in HMO. - No health maintenance organization may prohibit any licensed physician, podiatrist,...
Section 38-33-300. Liability for participation in quality of care or utilization review. - There may be no monetary liability on the part of,...
Section 38-33-310. HMO may contract with out-of-state provider. - Nothing in this chapter may be construed to prevent a...
Section 38-33-325. Obstetrician-gynecologist services; referrals; authorization for services; member notification of plan provisions. - (A) A health benefit plan shall allow a female enrollee...