Chapter 41 - HEALTH MAINTENANCE ORGANIZATIONS
- Section 58-41-1 - Definition of terms
- Section 58-41-2 - Organizations subject to chapter
- Section 58-41-3 - Certificate of authority required for health maintenance organization or contracts-Violation as misdemeanor
- Section 58-41-4 - Application for certificate of authority required
- Section 58-41-5 - [Repealed]
- Section 58-41-6 - Verification and form of application-Contents
- Section 58-41-7 - Financial statements required with application
- Section 58-41-8 - Copies of forms required with application
- Section 58-41-9 - Marketing, charges, and financial plans required with application
- Section 58-41-10 - Appointment to receive process required of foreign applicant
- Section 58-41-11 - Surety bond or deposit required-Waiver
- Section 58-41-12 - Determination of health care qualifications
- Section 58-41-13 - Coordination with federal professional standards review
- Section 58-41-14 - Obsolete
- Section 58-41-15 - Health maintenance not considered practice of healing arts
- Section 58-41-15.1 - Certain healing arts practitioners to participate in alternate health care delivery systems
- Section 58-41-16 - [Repealed]
- Section 58-41-17 - Issuance or denial of certificate-Fee-Conditions for issuance
- Section 58-41-18 - Factors considered in determining financial responsibility
- Section 58-41-19 - Insurance arrangements permitted
- Section 58-41-20 - Corporation operating after certification
- Section 58-41-21 - Foreign corporations qualifying-Exemption from other requirements
- Section 58-41-22 - Filing of notice of modification of operation-Approval if not disapproved-Exemptions
- Section 58-41-23 - Composition of governing body-Consumer representation
- Section 58-41-24 - Mechanisms for enrollee participation in policy and operation of governing body
- Section 58-41-25 - Fiduciary responsibilities to enrollees
- Section 58-41-25.1 - Investments
- Section 58-41-26 - Exemption from insurance laws-Exceptions-Taxation
- Section 58-41-27 - [Repealed]
- Section 58-41-28 - Solicitation of enrollment not deemed professional advertising
- Section 58-41-29 - Contracts and necessary activities
- Section 58-41-29.1 - Notice required for rate increase in health maintenance contract by a health maintenance organization
- Section 58-41-30 - Sources of payment for enrollee services-Application by medical assistance recipient
- Section 58-41-31 - Direct payments to enrollees prohibited
- Section 58-41-32 - Use of words descriptive of insurance, casualty, or surety business as misdemeanor-Exception
- Section 58-41-33 - Trade practice laws applicable
- Section 58-41-34 - Evidence of coverage issued to enrollees
- Section 58-41-35 - Contents required in evidence of coverage
- Section 58-41-35.1 - Alcoholism coverage to be offered at time contract is negotiated
- Section 58-41-35.2 to 58-41-35.4 - [Repealed]
- Section 58-41-35.5 - Grandfathered contracts required to cover low-dose mammography-Extent of coverage
- Section 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
- Section 58-41-35.7 - Contracts required to cover occult breast cancer screening
- Section 58-41-36 - Unfair and misleading information in evidence of coverage as misdemeanor
- Section 58-41-37 - Deceptive advertising or evidence of coverage as misdemeanor
- Section 58-41-38 - Statements deemed untrue
- Section 58-41-39 - Statements deemed misleading
- Section 58-41-40 - Evidence of coverage deemed deceptive
- Section 58-41-41 - Issuance to enrollees of change in evidence of coverage
- Section 58-41-42 - Evidence of coverage to be approved before use-Violation as misdemeanor
- Section 58-41-43 - Filing and approval requirements applicable
- Section 58-41-44 - Charges to enrollees-Fairness-Actuary's certificate
- Section 58-41-45 - Discrimination as misdemeanor
- Section 58-41-46 to 58-41-49 - [Repealed]
- Section 58-41-50 - Authorized expenses
- Section 58-41-51 - [Repealed]
- Section 58-41-51.1 - Individual policy required for covered spouse of insured-Eligibility-Coverage-Waiting periods
- Section 58-41-51.2 - Conversion privileges of insured's spouse upon divorce
- Section 58-41-51.3 - Continuation and conversion coverage to be offered
- Section 58-41-52 - Contracts with providers of health care services
- Section 58-41-52.1 - Collection for covered services prohibited
- Section 58-41-52.2 - Contracts-Hold harmless provision
- Section 58-41-52.3 - Hold harmless provision-Language of provision
- Section 58-41-53 - [Repealed]
- Section 58-41-54 - Contracts with insurance companies and nonprofit health service plan corporations authorized-Limitations
- Section 58-41-55 - Insurance contracts authorized-Group coverage-Benefit payments
- Section 58-41-56 - Contracts for management and administrative services authorized
- Section 58-41-57 - Payment of unreasonably high expenses as misdemeanor
- Section 58-41-58 to 58-41-62 - [Repealed]
- Section 58-41-63 - General annual report required-Form and contents
- Section 58-41-64 - [Repealed]
- Section 58-41-65 - Applications, filings and reports as public documents
- Section 58-41-66 - Annual summary for enrollees required-Contents
- Section 58-41-67 - Promulgation of rules
- Section 58-41-68 to 58-41-72 - [Repealed]
- Section 58-41-73 - Physician-patient privileges
- Section 58-41-74 - Confidential data-Exceptions
- Section 58-41-75, 58-41-76 - [Repealed]
- Section 58-41-77 - [Repealed]
- Section 58-41-78 - Cease and desist orders
- Section 58-41-79 - Hearing on cease and desist order-Procedure-Judicial review
- Section 58-41-80 - Injunctive relief against violations-Venue
- Section 58-41-81 - Suspension or revocation of certificate of authority on findings by director
- Section 58-41-82 - Additional grounds for suspension or revocation
- Section 58-41-83 - Voluntary conference before commencing actions for violation
- Section 58-41-84 - Informality in voluntary conferences
- Section 58-41-85 - Money penalty in lieu of suspension or revocation
- Section 58-41-86 - Requirements for suspension or revocation
- Section 58-41-86.1 - Suspension without notice or hearing
- Section 58-41-87 - Notice of grounds for denial, suspension, or revocation of certificate-Time of hearing-Summary proceedings excepted
- Section 58-41-88 - Administrative procedure and rules
- Section 58-41-89 - [Repealed]
- Section 58-41-90 - Action of director after hearing-Written findings
- Section 58-41-91 - Judicial review
- Section 58-41-92 - Activities prohibited during suspension of certificate
- Section 58-41-93 - Winding up after revocation of certificate-Continued operation to protect enrollees
- Section 58-41-94 - Summary proceeding to reorganize organization-Grounds
- Section 58-41-95 - Rehabilitation, liquidation, or conservation under insurance company laws
- Section 58-41-96 - Severability of provisions
- Section 58-41-97 - Citation of chapter
- Section 58-41-98 - Coverage for phenylketonuria
- Section 58-41-99 - Formation of voluntary health insurance purchasing organizations
- Section 58-41-100 - Membership of voluntary health insurance purchasing organizations
- Section 58-41-101 - Purchasing organization's responsibility for negotiating terms and conditions
- Section 58-41-102 - Purchasing organization's notice of premium charge
- Section 58-41-103 - Additional chapters applicable to purchasing organization
- Section 58-41-104 - Approval of purchasing organization by Division of Insurance
- Section 58-41-105 - Premiums held in trust by purchasing organization
- Section 58-41-106 - Rates for group health insurance issued to purchasing organizations
- Section 58-41-107 - Reasonable participation requirements for group members of purchasing organizations
- Section 58-41-108 - Purchasing organizations exempt from antitrust provisions
- Section 58-41-109 - Promulgation of rules for purchasing organizations
- Section 58-41-110 - Application of chapter to provider contracting with state
- Section 58-41-111 - Application of chapter to provider contracting with licensed health maintenance organization
- Section 58-41-112 - Minimum inpatient care coverage following delivery
- Section 58-41-113 - Shorter hospital stay permitted-Follow-up visit within forty-eight hours required
- Section 58-41-114 - Notice to enrollees-Disclosures
- Section 58-41-115 - Health insurance policies to provide coverage for biologically-based mental illnesses
- Section 58-41-116 - Application-Exemptions
- Section 58-41-117 - Policies to provide coverage for diabetes supplies, equipment, and education-Exceptions-Conditions and limitations
- Section 58-41-118 - Diabetes coverage not required of certain plans and policies
- Section 58-41-119 - Contracts to provide coverage for prostate cancer screening
- Section 58-41-120 - Annual report on risk bearing entities
- Section 58-41-121 - Documents provided to risk bearing entity by health maintenance organization
- Section 58-41-122 - Documents provided to health maintenance organization by risk bearing entity
- Section 58-41-123 - Notice by risk bearing entity of change in conditions-Assignment of contract
- Section 58-41-124 - Notice to director that risk bearing entity has materially failed to perform contract
- Section 58-41-125 - Confidentiality of information
- Section 58-41-126 - Nontransferable responsibilities of health maintenance organization
- Section 58-41-127 - Coverage for treatment of hearing impairment for persons under age nineteen