44-32,122 Health maintenance organization; powers.

NE Code § 44-32,122 (2019) (N/A)
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44-32,122. Health maintenance organization; powers.

The powers of a health maintenance organization shall include, but not be limited to, the following:

(1) The purchase, lease, construction, renovation, operation, or maintenance of hospitals, medical facilities, and ancillary equipment and such property as may reasonably be required for its principal office or for such purposes as may be necessary in the transaction of the business of the health maintenance organization;

(2) Transactions between affiliated entities, including loans and the transfer of responsibility under all contracts, including provider and subscriber contracts, between affiliates or between the health maintenance organization and its parent;

(3) Furnishing of basic health care services through providers, provider associations, or agents for providers which are under contract with or employed by the health maintenance organization;

(4) Contracting with any person for the performance on its behalf of certain functions such as marketing, enrollment, and administration;

(5) Contracting with an insurance company licensed in this state for the provision of insurance, indemnity, or reimbursement against the cost of health care services provided by the health maintenance organization;

(6) Offering of other health care services in addition to basic health care services. Nonbasic health care services may be offered by a health maintenance organization on a prepaid basis without offering basic health care services to any group or individual; and

(7) The joint marketing of products with an insurance company licensed in this state as long as the company that is offering each product is clearly identified.

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