P.R. Laws tit. 26, § 9291
(a) The Commissioner may suspend or revoke the certificate of authority issued to a limited health service organization pursuant to this chapter upon determining that any of the following conditions exist:
(1) The limited health service organization is operating significantly in contravention of its basic organizational document;
(2) the limited health service organization issues an evidence of coverage or uses rates or charges that do not meet the requirements of §§ 9279 and 9280 of this title;
(3) the limited health service organization is unable to fulfill its obligations to furnish limited health services;
(4) the limited health service organization is not financially sound and may reasonably be expected to be unable to meet its obligations to subscribers or prospective subscribers;
(5) the tangible net equity of the limited health service organization is less than required under § 9288 of this title, or such organization has failed to correct any deficiency in its tangible net equity as required by the Commissioner;
(6) the limited health service organization has failed to implement in a reasonable manner the grievance system required under § 9283 of this title;
(7) the continued operation of the limited health service organization would be hazardous to its subscribers;
(8) the limited health service organization has otherwise failed to comply with this Code, the Insurance Code of Puerto Rico, rule, regulation, or lawful order of the Commissioner, or
(9) the organization or any person acting on its behalf has advertised or marketed its services in a deceitful, unfair, or misleading manner.
(b) If the Commissioner has cause to believe that grounds for the suspension or revocation of a certificate of authority exist, he/she shall notify the limited health service organization in writing specifically stating the grounds for suspension or revocation and fixing the date not more than thirty (30) days thereafter for a hearing.
(c) When the certificate of authority of a limited health service organization is revoked, the organization shall proceed immediately to wind up its affairs, and shall conduct no further business except as may be essential to the orderly cease of operations. It shall engage in no further advertising or solicitation whatsoever. The Commissioner may, by written order, permit such further operation of the organization as he/she may find to be in the best interest of subscribers, to the end that subscribers will be afforded the greatest practical opportunity to obtain continuing limited health services.
History —Aug. 29, 2011, No. 194, added as § 16.210 on Aug. 23, 2012, No. 203, § 2, eff. 90 days after Aug. 23, 2012.