Any rehabilitation, liquidation or conservation of a health maintenance organization shall be considered to be the rehabilitation, liquidation or conservation of an insurance company, shall be the exclusive remedy for rehabilitation, liquidation and conservation of an HMO as provided by this article and shall be conducted under the supervision of the commissioner pursuant to the law governing the rehabilitation, liquidation or conservation of insurance companies. The commissioner may apply for an order directing him or her to rehabilitate, liquidate or conserve a health maintenance organization upon any one or more grounds set out in the rehabilitation statutes or when, in his or her opinion, the continued operation of the health maintenance organization would be hazardous either to the enrollees or to the people of this state.
Structure West Virginia Code
Article 25A. Health Maintenance Organization Act
§33-25A-1. Short Title and Purpose
§33-25A-3. Application for Certificate of Authority
§33-25A-4. Issuance of Certificate of Authority
§33-25A-5. Powers of Health Maintenance Organizations
§33-25A-7a. Provider Contracts
§33-25A-8a. Third Party Reimbursement for Mammography, Pap Smear or Human Papilloma Virus Testing
§33-25A-8b. Third Party Reimbursement for Rehabilitation Services
§33-25A-8c. Third Party Payment for Child Immunization Services
§33-25A-8d. Coverage of Emergency Services
§33-25A-8e. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing
§33-25A-8f. Required Coverage for Reconstruction Surgery Following Mastectomies
§33-25A-8g. Required Use of Mail-Order Pharmacy Prohibited
§33-25A-8h. Third-Party Reimbursement for Kidney Disease Screening
§33-25A-8i. Third-Party Reimbursement for Dental Anesthesia Services
§33-25A-8j. Coverage for Diagnosis and Treatment of Autism Spectrum Disorders
§33-25A-8k. Maternity Coverage
§33-25A-8l. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications
§33-25A-8m. Eye Drop Prescription Refills
§33-25A-8n. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs
§33-25A-8p. Lyme Disease to Be Covered by All Health Insurance Policies
§33-25A-8q. Coverage for Amino Acid-Based Formulas
§33-25A-8r. Substance Use Disorder
§33-25A-8s. Prior Authorization
§33-25A-8t. Fairness in Cost-Sharing Calculation
§33-25A-8u. Mental Health Parity
§33-25A-8v. Incorporation of the Health Benefit Plan Access and Adequacy Act
§33-25A-8w. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs
§33-25A-10. Information to Enrollees
§33-25A-11. Open Enrollment Period
§33-25A-12. Grievance Procedure
§33-25A-14. Prohibited Advertising Practices
§33-25A-14a. Other Prohibited Practices
§33-25A-15. Agent Licensing and Appointment Required; Regulation of Marketing
§33-25A-16. Powers of Insurers and Hospital and Medical Service Corporations
§33-25A-17a. Quality Assurance
§33-25A-18. Suspension or Revocation of Certificate of Authority
§33-25A-19. Rehabilitation, Liquidation or Conservation of Health Maintenance Organization
§33-25A-21. Administrative Procedures
§33-25A-23. Penalties and Enforcement
§33-25A-23a. Civil Penalty Imposed by Commissioner
§33-25A-24. Scope of Provisions; Applicability of Other Laws
§33-25A-25. Filings and Reports as Public Documents
§33-25A-26. Confidentiality of Medical Information
§33-25A-27. Authority to Contract With Health Maintenance Organizations Under Medicaid
§33-25A-28. Required Health Maintenance Organization Option
§33-25A-31. Policies Discriminating Among Health Care Providers
§33-25A-34. Ambulance Services
§33-25A-35. Rural Health Maintenance Organizations
§33-25A-36. Assignment of Certain Benefits in Dental Care Insurance Coverage