§ 20-3213 – Applicability
20-3213. Applicability A. A provider lawfully transacting business in this state before the effective date of this chapter may continue to transact business in this state, pending approval or disapproval of that person’s application for a license, if the provider files the application with the director not later than thirty days after publication by the […]
§ 20-3214 – Injunctions; civil remedies; cease and desist
20-3214. Injunctions; civil remedies; cease and desist A. In addition to the penalties and other enforcement provisions of this chapter, if any person violates any provision of this chapter or any rule adopted pursuant to this chapter, the director may seek an injunction in a court of competent jurisdiction in the county where the person […]
§ 20-3215 – Penalties
20-3215. Penalties A. It is a violation of this chapter for any person, provider, broker or party related to the business of life settlements to commit a fraudulent life settlement act. B. A person who commits a fraudulent life settlement act is guilty of committing insurance fraud and is subject to section 20-466.01. C. The […]
§ 20-3251 – Interstate insurance product regulation compact
20-3251. Interstate insurance product regulation compact The interstate insurance product regulation compact is enacted into law as follows: Article I Purpose Under the terms and conditions of this compact, this state seeks to join with other states and establish the interstate insurance product regulation compact and thus become a member of the interstate insurance product […]
§ 20-3301 – Definitions; applicability
20-3301. Definitions; applicability A. In this article, unless the context otherwise requires: 1. " Insurance compliance audit" means a voluntary, internal evaluation, review, assessment, audit or investigation that follows adopted written standards and criteria for the purpose of identifying or preventing noncompliance with or promoting compliance with laws, regulations, orders or industry or professional standards […]
§ 20-3302 – Insurance compliance audit privilege; requirements
20-3302. Insurance compliance audit privilege; requirements A. Except as provided in subsections E and F of this section, an insurance compliance audit document is privileged information and is not discoverable or admissible as evidence in any legal action in any civil or administrative proceeding other than a regulatory or legal action brought as part of […]
§ 20-3321 – Definitions
20-3321. Definitions In this chapter, unless the context otherwise requires: 1. " Auditing entity" means any person, company, group or plan working on behalf of or pursuant to a contract with an insurer or pharmacy benefits manager for the purposes of auditing pharmacy drug claims adjudicated by pharmacies. 2. " Clerical errors" means a minor […]
§ 20-3112 – Applicability
20-3112. Applicability This article does not apply to: 1. Health care services that are not covered by the enrollee’s health plan. 2. Limited benefit coverage as defined in section 20-1137. 3. Charges for health care services that are subject to a direct payment agreement under section 32-3216 or 36-437. 4. Health plans that do not […]
§ 20-3204 – Provider and broker disclosures to owners; violation; classification
20-3204. Provider and broker disclosures to owners; violation; classification A. The provider or broker shall provide in writing the following information, in a separate document that is signed by the owner and provider, to the owner no later than the date of application for the life settlement contract: 1. That there are possible alternatives to […]
§ 20-3113 – Surprise out-of-network bill; requirements; notice
20-3113. Surprise out-of-network bill; requirements; notice A. A bill for a health care service that was provided in a network facility by a health care provider that is not a contracted provider must meet one of the following requirements to qualify as a surprise out-of-network bill: 1. The bill was for emergency services, including under […]