HEALTH MAINTENANCE ORGANIZATIONS
58-41-1 Definition of terms.
58-41-2 Organizations subject to chapter.
58-41-3 Certificate of authority required for health maintenance organization or contracts--Violation as misdemeanor.
58-41-4 Application for certificate of authority required.
58-41-6 Verification and form of application--Contents.
58-41-7 Financial statements required with application.
58-41-8 Copies of forms required with application.
58-41-9 Marketing, charges, and financial plans required with application.
58-41-10 Appointment to receive process required of foreign applicant.
58-41-11 Surety bond or deposit required--Waiver.
58-41-12 Determination of health care qualifications.
58-41-13 Coordination with federal professional standards review.
58-41-15 Health maintenance not considered practice of healing arts.
58-41-15.1 Certain healing arts practitioners to participate in alternate health care delivery systems.
58-41-17 Issuance or denial of certificate--Fee--Conditions for issuance.
58-41-18 Factors considered in determining financial responsibility.
58-41-19 Insurance arrangements permitted.
58-41-20 Corporation operating after certification.
58-41-21 Foreign corporations qualifying--Exemption from other requirements.
58-41-22 Filing of notice of modification of operation--Approval if not disapproved--Exemptions.
58-41-23 Composition of governing body--Consumer representation.
58-41-24 Mechanisms for enrollee participation in policy and operation of governing body.
58-41-25 Fiduciary responsibilities to enrollees.
58-41-26 Exemption from insurance laws--Exceptions--Taxation.
58-41-28 Solicitation of enrollment not deemed professional advertising.
58-41-29 Contracts and necessary activities.
58-41-29.1 Notice required for rate increase in health maintenance contract by a health maintenance organization.
58-41-30 Sources of payment for enrollee services--Application by medical assistance recipient.
58-41-31 Direct payments to enrollees prohibited.
58-41-32 Use of words descriptive of insurance, casualty, or surety business as misdemeanor--Exception.
58-41-33 Trade practice laws applicable.
58-41-34 Evidence of coverage issued to enrollees.
58-41-35 Contents required in evidence of coverage.
58-41-35.1 Alcoholism coverage to be offered at time contract is negotiated.
58-41-35.2 to 58-41-35.4. Repealed.
Grandfathered contracts required to cover low-dose mammography--Extent of coverage. 58-41-35.6
Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony. 58-41-35.7
Contracts required to cover occult breast cancer screening. 58-41-36
Unfair and misleading information in evidence of coverage as misdemeanor. 58-41-37
Deceptive advertising or evidence of coverage as misdemeanor. 58-41-38
Statements deemed untrue. 58-41-39
Statements deemed misleading. 58-41-40
Evidence of coverage deemed deceptive. 58-41-41
Issuance to enrollees of change in evidence of coverage. 58-41-42
Evidence of coverage to be approved before use--Violation as misdemeanor. 58-41-43
Filing and approval requirements applicable. 58-41-44
Charges to enrollees--Fairness--Actuary's certificate. 58-41-45
Discrimination as misdemeanor. 58-41-46
to 58-41-49. Repealed. 58-41-50
Authorized expenses. 58-41-51
Individual policy required for covered spouse of insured--Eligibility--Coverage--Waiting periods. 58-41-51.2
Conversion privileges of insured's spouse upon divorce. 58-41-51.3
Continuation and conversion coverage to be offered. 58-41-52
Contracts with providers of health care services. 58-41-53
Contracts with insurance companies and nonprofit health service plan corporations authorized--Limitations. 58-41-55
Insurance contracts authorized--Group coverage--Benefit payments. 58-41-56
Contracts for management and administrative services authorized. 58-41-57
Payment of unreasonably high expenses as misdemeanor. 58-41-58
to 58-41-62. Repealed. 58-41-63
General annual report required--Form and contents. 58-41-64
Applications, filings and reports as public documents. 58-41-66
Annual summary for enrollees required--Contents. 58-41-67
Promulgation of rules. 58-41-68
to 58-41-72. Repealed. 58-41-73
Physician-patient privileges. 58-41-74
Confidential data--Exceptions. 58-41-75
, 58-41-76. Repealed. 58-41-77
Cease and desist orders. 58-41-79
Hearing on cease and desist order--Procedure--Judicial review. 58-41-80
Injunctive relief against violations--Venue. 58-41-81
Suspension or revocation of certificate of authority on findings by director. 58-41-82
Additional grounds for suspension or revocation. 58-41-83
Voluntary conference before commencing actions for violation.
Informality in voluntary conferences. 58-41-85
Money penalty in lieu of suspension or revocation. 58-41-86
Requirements for suspension or revocation. 58-41-86.1
Suspension without notice or hearing. 58-41-87
Notice of grounds for denial, suspension, or revocation of certificate--Time of hearing--Summary proceedings excepted. 58-41-88
Administrative procedure and rules. 58-41-89
Action of director after hearing--Written findings. 58-41-91
Judicial review. 58-41-92
Activities prohibited during suspension of certificate. 58-41-93
Winding up after revocation of certificate--Continued operation to protect enrollees. 58-41-94
Summary proceeding to reorganize organization--Grounds. 58-41-95
Rehabilitation, liquidation, or conservation under insurance company laws. 58-41-96
Severability of provisions. 58-41-97
Citation of chapter. 58-41-98
Coverage for phenylketonuria. 58-41-99
Formation of voluntary health insurance purchasing organizations. 58-41-100
Membership of voluntary health insurance purchasing organizations. 58-41-101
Purchasing organization's responsibility for negotiating terms and conditions. 58-41-102
Purchasing organization's notice of premium charge. 58-41-103
Additional chapters applicable to purchasing organization. 58-41-104
Approval of purchasing organization by Division of Insurance. 58-41-105
Premiums held in trust by purchasing organization. 58-41-106
Rates for group health insurance issued to purchasing organizations. 58-41-107
Reasonable participation requirements for group members of purchasing organizations. 58-41-108
Purchasing organizations exempt from antitrust provisions. 58-41-109
Promulgation of rules for purchasing organizations. 58-41-110
Application of chapter to provider contracting with state. 58-41-111
Application of chapter to provider contracting with licensed health maintenance organization. 58-41-112
Minimum inpatient care coverage following delivery. 58-41-113
Shorter hospital stay permitted--Follow-up visit within forty-eight hours required. 58-41-114
Notice to enrollees--Disclosures. 58-41-115
Health insurance policies to provide coverage for biologically-based mental illnesses. 58-41-116
Policies to provide coverage for diabetes supplies, equipment, and education--Exceptions--Conditions and limitations. 58-41-118
Diabetes coverage not required of certain plans and policies. 58-41-119
Contracts to provide coverage for prostate cancer screening. 58-41-120
Annual report on risk bearing entities. 58-41-121
Documents provided to risk bearing entity by health maintenance organization. 58-41-122
Documents provided to health maintenance organization by risk bearing entity. 58-41-123
Notice by risk bearing entity of change in conditions--Assignment of contract. 58-41-124
Notice to director that risk bearing entity has materially failed to perform contract. 58-41-125
Confidentiality of information. 58-41-126
Nontransferable responsibilities of health maintenance organization. 58-41-127
Coverage for treatment of hearing impairment for persons under age nineteen.