D.C. Mun. Regs. tit. 26, r. 26-A3502

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 26-A3502 - POWERS OF HMOS

3502.1

The powers of an HMO include, but are not limited to, the following:

(a) The purchase, lease, construction, renovation, operation or maintenance of hospitals, medical facilities, or both, and their ancillary equipment, and such property and equipment as may be reasonably required by the HMO for its principal office or for such purposes as may be necessary for transacting the organization's business;

(b) Conducting transactions between affiliated entities; and

(c) Contracting with any person for the performance of marketing, enrollment and administration functions.

3502.2

The exercise of any power under subsection 3502.1 which does not have a monetary value in excess of ten percent (10%) of the admitted assets or 25% of the HMO's net worth as reflected on the most recent quarterly report filed with the Commissioner shall be deemed "de minimus" and no approval shall be required from the Commissioner.

3502.3

A request by the HMO to exercise a power is considered approved if the Commissioner fails to disapprove the request within thirty (30) days of the filing of the notice.

3502.4

Joint marketing with an insurance company is permissible as long as each product is clearly identified with the company making the offer.

D.C. Mun. Regs. tit. 26, r. 26-A3502

Final Rulemaking published at 46 DCR 7291(September 17, 1999)