Ala. Admin. Code r. 420-5-6-.03

Current through Register Vol. 42, No. 7, April 30, 2024

Section 420-5-6-.03 - Review By The Department

(1) Within the statutory time frames, the Department will determine whether the information submitted in the application for a Certificate of Authority is complete. If the information is not complete, the Department will send notification in writing to the applicant stating that additional information is needed. In this event, the Department may require the organization to provide proof that all Department of Insurance requirements have been satisfied before accepting further Certificate of Authority submissions. Failure to meet all Alabama Department of Public Health requirements for a properly completed application in a ten-month period may result in the organization being required to begin the application process again.

(2) Before the Department certifies to the Insurance Commissioner that the proposed health maintenance organization meets the requirements of 420-5-6-.02, it will conduct a thorough assessment to ascertain whether the proposed health maintenance organization, the plan under which it proposes to operate, and the services which it proposes to provide are consistent with the purposes and provisions of Code of Ala. 1975, §§ 27-21A-1, etseq., and this Chapter.

(3) Within 90 days of receipt of a properly completed application for a Certificate of Authority, the State Health Officer will do either of the following:

(a) Certify to the Insurance Commissioner that the proposed health maintenance organization meets all requirements of the State Board of Health; or

(b) Disapprove the application, specifying in writing to the proposed health maintenance organization and Insurance Commissioner the reasons for such disapproval.

Author: Department of Public Health

Ala. Admin. Code r. 420-5-6-.03

Filed September 1, 1982. Repealed and New Rule adopted in lieu thereof: Filed March 31, 1987. Amended: Filed January 20, 1999; effective February 24, 1999.

Statutory Authority:Code of Ala. 1975, §§ 22-2-2(6), etseq., 22-21-20, etseq., 27-21A-1, etseq.