CHAPTER 58-41
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.
58-41-5 58-41-5. Repealed by SL 1985, ch 393, § 7
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.
58-41-16 58-41-16. Repealed by SL 2013, ch 256, § 7.
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.
58-41-25.1 Investments.
58-41-26 Exemption from insurance laws--Exceptions--Taxation.
58-41-27 58-41-27. Repealed by SL 1985, ch 393, § 9
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 58-41-35.2 to 58-41-35.4. Repealed by SL 2001, ch 274, §§ 10 to 12
58-41-35.5 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 58-41-46 to 58-41-49. Repealed by SL 2013, ch 256, §§ 12 to 15.
58-41-50 Authorized expenses.
58-41-51 58-41-51. Repealed by SL 2013, ch 256, § 16.
58-41-51.1 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.
58-41-52.1 Collection for covered services prohibited.
58-41-52.2 Contracts--Hold harmless provision.
58-41-52.3 Hold harmless provision--Language of provision.
58-41-53 58-41-53. Repealed by SL 1999, ch 245, § 21
58-41-54 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 58-41-58 to 58-41-62. Repealed by SL 1996, ch 296, §§ 9 to 13
58-41-63 General annual report required--Form and contents.
58-41-64 58-41-64. Repealed by SL 1985, ch 393, § 10
58-41-65 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 58-41-68 to 58-41-72. Repealed by SL 2013, ch 256, §§ 20 to 24.
58-41-73 Physician-patient privileges.
58-41-74 Confidential data--Exceptions.
58-41-75 58-41-75, 58-41-76. Repealed by SL 2013, ch 256, §§ 25, 26.
58-41-77 58-41-77. Repealed by SL 1978, ch 359, § 3
58-41-78 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.
58-41-84 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 58-41-89. Repealed by SL 2013, ch 256, § 32.
58-41-90 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 Application--Exemptions.
58-41-117 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.