CHAPTER 27-41
Health Maintenance Organizations
Index Of Sections
§ 27-41-1 Short title.
§ 27-41-2 Definitions.
§ 27-41-3 Establishment of health maintenance organizations.
§ 27-41-4 Issuance of license.
§ 27-41-5 Powers of health maintenance organizations.
§ 27-41-6 Governing body.
§ 27-41-7 Fiduciary responsibilities.
§ 27-41-8 Evidence of coverage and charges for health care services.
§ 27-41-9 Required reports.
§ 27-41-10 Information to enrollees.
§ 27-41-11 Complaint system.
§ 27-41-12 Investments.
§ 27-41-13 Protection against insolvency.
§ 27-41-13.1 Initial net worth and capital requirements.
§ 27-41-13.2 Ongoing net worth and capital requirements.
§ 27-41-13.3 Waiver, surplus notes, and risk based capital requirements.
§ 27-41-14 Prohibited practices.
§ 27-41-14.1 Prohibition against restraint on provider – Patient communications.
§ 27-41-15 Powers of insurers and hospital and medical service corporations.
§ 27-41-16 Examination.
§ 27-41-17 Suspension or revocation of license.
§ 27-41-18 Rehabilitation, liquidation, or conservation of health maintenance organization.
§ 27-41-18.1 Summary orders and supervision.
§ 27-41-19 Rules and regulations.
§ 27-41-20 Administrative procedures.
§ 27-41-21 Penalties and enforcement.
§ 27-41-22 Statutory construction and relationship to other laws.
§ 27-41-23 Filings and reports as public documents.
§ 27-41-24 Director of health's authority to contract.
§ 27-41-25 Holding company systems.
§ 27-41-26 Enrollee liability.
§ 27-41-26.1 Patient responsibility – Administrative requirements.
§ 27-41-27 Offer of health maintenance organization alternative to employees.
§ 27-41-27.1 No derogation of attorney general.
§ 27-41-27.2 Health insurance rates.
§ 27-41-28 Applicability.
§ 27-41-29 Severability.
§ 27-41-29.1 Uniform explanation of benefits and coverage.
§ 27-41-29.2 Filing of policy forms.
§ 27-41-30 Mammograms and pap smears – Coverage mandated.
§ 27-41-30.1 Post-partum hospital stays.
§ 27-41-31 Mammograms – Quality assurance standards.
§ 27-41-32 Pap smears – Quality assurance standards.
§ 27-41-33 Coverage for infertility.
§ 27-41-34 Health maintenance organizations' assessment.
§ 27-41-35 Enrollment period in the event of insolvency.
§ 27-41-36 Services of midwives.
§ 27-41-37 Discontinuance of coverage – Chronic disabilities.
§ 27-41-38 Drug coverage.
§ 27-41-39 Certified registered nurse practitioners and psychiatric and mental health nurse clinical specialists.
§ 27-41-40 Certified counselors in mental health and therapists in marriage and family practice.
§ 27-41-41 Repealed.
§ 27-41-41.1 Repealed.
§ 27-41-41.2 Repealed.
§ 27-41-41.3 Repealed.
§ 27-41-42 Repealed.
§ 27-41-43 Mastectomy treatment.
§ 27-41-43.1 Insurance coverage for mastectomy hospital stays.
§ 27-41-44 Diabetes treatment.
§ 27-41-45 Primary and preventive obstetric and gynecological care.
§ 27-41-46 Whistleblowers protection.
§ 27-41-47 Penalties and remedies.
§ 27-41-48 Additional relief and damages – Reinstatement.
§ 27-41-49 Third party reimbursement for services of certain health care workers.
§ 27-41-49.1 Third party reimbursement for services of registered nurse first assistants.
§ 27-41-50 Human leukocyte antigen testing.
§ 27-41-51 Drug coverage.
§ 27-41-52 Restricted annual rate payments prohibited.
§ 27-41-53 Genetic testing.
§ 27-41-53.1 Genetic information.
§ 27-41-54 Disassociation prohibited.
§ 27-41-55 Repealed.
§ 27-41-56 Magnetic resonance imaging – Quality assurance standards.
§ 27-41-57 Acupuncture services.
§ 27-41-58 Prohibition against requiring indemnification from dentists.
§ 27-41-59 F.D.A. approved prescription contraceptive drugs and devices.
§ 27-41-60 Prostate and colorectal examinations – Coverage mandated.
§ 27-41-61 Eligibility for children's benefits.
§ 27-41-62 Temporary credentials.
§ 27-41-63 Hearing aids.
§ 27-41-64 Prompt processing of claims.
§ 27-41-65 Mandatory coverage for certain lyme disease treatments.
§ 27-41-66 Dental insurance assignment of benefits.
§ 27-41-67 Determination of maximum coverage limitation for prescription drug benefits.
§ 27-41-68 Coverage for early intervention services.
§ 27-41-69 Post-payment audits.
§ 27-41-70 Tobacco cessation programs.
§ 27-41-71 Mandatory coverage for scalp hair prosthesis.
§ 27-41-72 Reimbursement for orthotic and prosthetic services.
§ 27-41-73 Licensed ambulance service.
§ 27-41-74 Enteral nutrition products.
§ 27-41-75 Prohibition on rescission of coverage.
§ 27-41-76 Prohibition on annual and lifetime limits.
§ 27-41-77 Coverage for individual participating in approved clinical trials.
§ 27-41-78 Medical loss ratio reporting and rebates.
§ 27-41-79 Emergency services.
§ 27-41-80 Internal and external appeal of adverse benefit determinations.
§ 27-41-81 Prohibition on preexisting condition exclusions.
§ 27-41-82 Primary care provider designation requirement. [Effective January 1, 2013.].