Chapter 33 - Health Maintenance Organizations

Chapter 33 - Health Maintenance Organizations

Section 38-33-10. Short title.
Section 38-33-20. Definitions.
Section 38-33-30. Necessity of certificate of authority; foreign corporation.
Section 38-33-40. Issuance of certificate of authority; criteria and considerations; arrangements for participation of providers in each geographic area served.
Section 38-33-50. Powers of health maintenance organization; notice prior to exercise of powers.
Section 38-33-60. Members of governing body; advisory panels, etc.
Section 38-33-70. Fiduciary relationship in handling of funds.
Section 38-33-80. Enrollee entitled to evidence of coverage; contents of evidence of coverage; discontinuance or replacement of coverage; charges for services.
Section 38-33-90. Statements and reports.
Section 38-33-100. Financial requirements before issuance of certificate of authority to health maintenance organization.
Section 38-33-110. Complaint procedures; reports; malpractice claims; applicability of Freedom of Information Act.
Section 38-33-120. Investment of funds.
Section 38-33-130. Security deposit; individual stop-loss coverage; provisions for unpaid claim liability; individual conversion policy.
Section 38-33-140. Advertisements; application of provisions relating to trade practices; use of term "insurer" or "health maintenance organization".
Section 38-33-150. Agent for organization; exemption from licensing requirements.
Section 38-33-160. Operation of health maintenance organization by insurance company; contracts for cost of care.
Section 38-33-170. Examination of affairs of organization; quality of health care services; books and records; expense of examination; reports.
Section 38-33-180. Suspension or revocation of certificate of authority.
Section 38-33-190. Rehabilitation, liquidation, or conservation of a health maintenance organization; priorities.
Section 38-33-200. Implementation of regulations.
Section 38-33-210. Notification of grounds for denial, suspension or revocation of certificate of authority; hearings; judicial review.
Section 38-33-220. Fees.
Section 38-33-230. Levy of administrative penalty in lieu of revocation or suspension of certificate of authority; monetary penalty; notice and hearings; injunctions.
Section 38-33-240. Application of provisions of insurance law or law relating to solicitation or advertising by health professionals; practice of medicine, dentistry or other healing profession.
Section 38-33-250. Records of organization as public documents; trade secrets, etc.
Section 38-33-260. Confidentiality of health records.
Section 38-33-270. Contractual powers of Department to assist in investigative duties; assessments for consulting expenses.
Section 38-33-280. Acquisition or exchange of securities of a health maintenance organization; merger or consolidation of HMO.
Section 38-33-290. Participation by physician, podiatrist, optometrist, or oral surgeon as provided in HMO.
Section 38-33-300. Liability for participation in quality of care or utilization review.
Section 38-33-310. HMO may contract with out-of-state provider.
Section 38-33-325. Obstetrician-gynecologist services; referrals; authorization for services; member notification of plan provisions.

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