Chapter 21 - Health Maintenance Organizations

Chapter 21 - Health Maintenance Organizations

§ 33-21-1. Definitions
§ 33-21-2. Procedure for establishment of health maintenance organizations generally; notice of modification; exemption of item from filing requirements
§ 33-21-3. Grounds and procedure for issuance or denial of certificate of authority; endorsement of change of address upon certificate of authority
§ 33-21-4. Annual license fee
§ 33-21-5. Suspension or revocation of certificate of authority
§ 33-21-6. Composition of governing body; duty to establish mechanism for participation by enrollees in matters of policy and operation
§ 33-21-7. Fiduciary responsibilities of directors, officers, or partners
§ 33-21-8. Powers of organizations generally; filing of notice of exercise of powers
§ 33-21-9. Establishment and maintenance of complaint system; maintenance of records of complaints; summary reports; examination of system
§ 33-21-10. Responsibility of organizations for financial risks of providing services generally; reinsurance of risks; deposit of cash or securities with Commissioner
§ 33-21-11. Investment of funds of organizations
§ 33-21-12. Participation in organizations by members of associations
§ 33-21-13. Evidence of coverage; filing and approval of basic rates and method of computation of coverage
§ 33-21-14. Annual information to enrollees
§ 33-21-15. Filing of annual reports; contents
§ 33-21-16. Fees and taxes
§ 33-21-17. Examinations of organizations and providers; reports of examinations; payment of expenses of examinations
§ 33-21-18. Adoption of rules and regulations generally
§ 33-21-18.1. Emergency services requirements; restrictive formulary requirements
§ 33-21-19. Promulgation of rules and regulations for licensing of agents
§ 33-21-20. Conduct of hearings generally; participation in hearings by commissioner of community health; judicial review
§ 33-21-20.1. Regulation of HMOs by commissioner of community health
§ 33-21-21. Authority of commissioner of community health to contract for making of recommendations required by chapter; acceptance of recommendations
§ 33-21-22. Applications, filings, and reports to be treated as public documents
§ 33-21-23. Confidentiality of medical information; claim of privileges by organizations
§ 33-21-24. Rehabilitation, liquidation, or conservation of organizations
§ 33-21-25. Organization and operation of health maintenance organizations by insurers or health care corporations
§ 33-21-26. Untrue or misleading statements; deceptive evidence of coverage; cancellation or nonrenewal of enrollees
§ 33-21-27. Enforcement of chapter; penalties for violations of chapter
§ 33-21-28. Applicability of provisions of title and of other laws to health maintenance organizations and representatives
§ 33-21-29. Point-of-service option for persons offered health care coverage through health maintenance organization

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