(a) When the commissioner 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 or she shall notify the prepaid limited health service organization in writing specifically stating the grounds for denial, suspension or revocation and fixing a time of at least twenty days thereafter for a hearing on the matter.
(b) After the hearing, or upon the failure of the prepaid limited health service organization to appear at the hearing, the commissioner shall take action as is considered advisable on written findings which shall be mailed to the prepaid limited health service organization. The action of the commissioner is subject to review. The court may modify, affirm or reverse the order of the commissioner, in whole or in part.
(c) Proceedings under this article are governed by the provisions of section thirteen, article two of this chapter.
Structure West Virginia Code
Article 25D. Prepaid Limited Health Service Organization Act
§33-25D-3. Application for Certificate of Authority; Addition of Services
§33-25D-5. Issuance of Certificate of Authority
§33-25D-7. Powers of Organization
§33-25D-8. Governing Body; Enrollee Participation
§33-25D-9. Fiduciary Responsibilities of Managers; Fidelity Bond
§33-25D-10. Provider Contracts
§33-25D-12. Annual and Quarterly Reports
§33-25D-13. Annual Report to Enrollees
§33-25D-14. Grievance Procedure
§33-25D-15. Prohibited Practices
§33-25D-16. Agent Licensing and Appointment Required; Regulation of Marketing
§33-25D-20. Suspension or Revocation of Certificate of Authority
§33-25D-23. Administrative Procedures
§33-25D-25. Penalties and Enforcement
§33-25D-26. Scope of Provisions; Applicability of Other Laws
§33-25D-27. Filings and Reports as Public Documents
§33-25D-28. Confidentiality of Medical Information
§33-25D-29. Authority to Contract With Prepaid Limited Health Service Organizations Under Medicaid