§33-25A-26. Confidentiality of Medical Information
Any data or information pertaining to the diagnosis, treatment or health of any enrollee or applicant obtained from that person or from any provider by any health maintenance organization shall be held in confidence and shall not be disclosed to any person except: (1) To the extent that it may be necessary to facilitate an […]
§33-25A-27. Authority to Contract With Health Maintenance Organizations Under Medicaid
The department of welfare is hereby authorized to enter into contracts with health maintenance organizations certified and permitted to market under the laws of this state, and to furnish to recipients of medical assistance under Title XIX of the Social Security Act, 42 U.S.C. Section 1396, et. seq., health care services offered to such recipients […]
§33-25A-22. Fees
Every health maintenance organization subject to this article shall pay to the Commissioner the following fees: For filing an application for a certificate of authority or amendment to the application, $200; for each renewal of a certificate of authority, the annual fee as provided in section thirteen, article three of this chapter; for each form […]
§33-25A-23. Penalties and Enforcement
(1) The Commissioner may, in lieu of suspension or revocation of a certificate of authority under section eighteen of this article, levy an administrative penalty in an amount not less than $100 nor more than $5,000, if reasonable notice in writing is given of the intent to levy the penalty and the health maintenance organization […]
§33-25A-15. Agent Licensing and Appointment Required; Regulation of Marketing
(1) Health maintenance organizations are subject to the provisions of article twelve of this chapter.
§33-25A-16. Powers of Insurers and Hospital and Medical Service Corporations
(1) An insurance company licensed in this state or a hospital or medical service corporation authorized to do business in this state, after applying for and receiving a certificate of authority as a health maintenance organization, may through a subsidiary or affiliate organize and operate a health maintenance organization under the provisions of this article. […]
§33-25A-17. Examinations
(a) The Commissioner may make an examination of the affairs of any health maintenance organization and providers with whom the organization has contracts, agreements or other arrangements as often as he or she considers it necessary for the protection of the interests of the people of this state but not less frequently than once every […]
§33-25A-17a. Quality Assurance
(a) Each health maintenance organization shall have in writing a quality assurance program that describes the program's objectives, organization and problem solving activities. (b) The scope of the quality assurance program shall include, at a minimum: (1) Organizational arrangements and responsibilities for quality management and improvement processes;
§33-25A-18. Suspension or Revocation of Certificate of Authority
(1) The commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization under this article if he or she finds that any of the following conditions exist:
§33-25A-19. Rehabilitation, Liquidation or Conservation of Health Maintenance Organization
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 […]