Current through Register Vol. XLI, No. 50, December 13, 2024
Section 85-21-6 - Approval by the Commission6.1. The Commission or upon termination of the Commission, the insurance commissioner, shall notify the applicant in writing of the determination made upon the application for certification or modification thereof, within sixty (60) days of receipt of a complete application. A denial shall be final and unappealable.6.2. A certificate shall be valid for a period of two (2) years and only for the service area and managed care plan or plans specified by the Commission or upon termination of the Commission, the insurance commissioner. Upon written request made at least sixty (60) days prior to expiration of the current certificate, the Commission may recertify a plan for additional successive two (2) year periods. Geographical areas may be added upon the filing of a supplemental application demonstrating the managed health care system's ability to serve the expanded area.6.3. If an application does not meet the requirements for certification or expansion, the Commission or upon termination of the Commission, the insurance commissioner, shall notify the applicant in writing and specify those items deemed deficient. The applicant is granted thirty (30) days from the date of notice by the Commission or upon termination of the Commission, the insurance commissioner, to correct deficiencies through an amended application.6.4. Certifications of a managed care plan are not transferable. A new application for certification must be filed when fifty (50) percent or more of the ownership or controlling interest of a system has been transferred.