CHAPTER 432D

HEALTH MAINTENANCE ORGANIZATION ACT

 

Section

432D-1 Definitions

432D-1.5 Bona fide trade associations

432D-2 Establishment of health maintenance organizations

432D-3 Powers of health maintenance organizations

432D-4 Fiduciary responsibilities

432D-5 Annual and quarterly reports

432D-6 Information to enrollees or subscribers

432D-7 Investments

432D-8 Protection against insolvency

432D-9 Uncovered expenditures insolvency deposit

432D-9.5 Reserve credit for reinsurance

432D-10 Enrollment period

432D-11 Replacement coverage

432D-12 Powers of insurers and hospital and medical service

corporations

432D-13 Examinations

432D-14 Suspension, revocation, or denial of certificate of

authority

432D-15 Rehabilitation, liquidation, or conservation of health

maintenance organizations

432D-16 Summary orders and supervision

432D-17 Fees

432D-18 Penalties and enforcement

432D-18.5 Repealed

432D-19 Statutory construction and relationship to other laws

432D-20 Filings and reports as public documents

432D-21 Confidentiality of medical information

432D-22 Acquisition of control of or merger of a health

maintenance organization

432D-23 Required provisions and benefits

432D-23.5 Coverage for telehealth

432D-23.6 Federally funded programs; exemption

432D-24 Coordination of benefits

432D-25 Disclosure of health care coverage and benefits

432D-26 Genetic information nondiscrimination in health

insurance coverage

432D-27 Policies relating to domestic abuse cases

432D-28 Federal law compliance

432D-29 Prohibition on rescissions of coverage

 

Note

 

Prescription drug benefits, mail order opt out; reports to 2014-2015 legislature; applicability. L 2013, c 226, 4, 5, 8.

 

Cross References

 

Assessments of health insurers, see 431:2-216.

Conformance to federal law, see 431:2-201.5.

Health care provider network adequacy, see chapter 432F.

Peer review, see 663-1.7.

Prescription drug benefits, see chapter 431R.

Prescription drugs; mail order opt out option, see 87A-16.3.

 

Attorney General Opinions

 

Section 431:10A-601 applied only to insurers, and not mutual benefit societies or health maintenance organizations. Att. Gen. Op. 97-5.

 

Case Notes

 

As this chapter does not cover the field of managed care regulation and because 432D-2, 432E-1, and article 431:10A can be read together and there is no explicit language or policy reason not to give each statute effect, this chapter does not repeal chapter 432E by implication. 126 H. 326, 271 P.3d 621 (2012).

Properly licensed HMOs, like plaintiff, were authorized pursuant to 432D-1 to "provide or arrange", at their option, for the closed panel health care services required under the managed care plan program; accident and health insurers were authorized under 431:10A-205(b) to arrange for medical services for members using a defined network of providers, i.e., particular "hospitals or persons"; thus, article 431:10A and this chapter authorized both accident and health insurers and HMOs, as risk-bearing entities, to provide the closed panel product required by the managed care plan contracts. 126 H. 326, 271 P.3d 621 (2012).

 

Previous Vol09_Ch0431-0435E Next