Subarticle - CHAPTER 35. HEALTH MAINTENANCE ORGANIZATIONS
- Section 500.3501 - Definitions
- Section 500.3503 - Applicability of provisions to health maintenance organization
- Section 500.3505 - Health maintenance contract; use of descriptive words; restrictions
- Section 500.3507 - Authorizing and regulating health maintenance organization; establishment of system by director
- Section 500.3508 - Quality assessment program; quality improvement program
- Section 500.3509 - Certificate of authority; application; form; limitation; change of service area
- Section 500.3511 - Governing body; election of enrollee board members; requirements; meetings
- Section 500.3513 - Health maintenance organization operations; regulation by director; incorporation as legal entity
- Section 500.3515 - Additional health services; deductibles; copayments; "preventive health care services" defined; partial payment from government or private person
- Section 500.3517 - Healthy lifestyle programs; emergency or out-of-area service; payment of expenses or fees
- Section 500.3519 - Contract and contract rates; fairness; rate differential; basic health services to large employers required
- Section 500.3521 - Prepayment rates; filing and approval of methodology; schedule
- Section 500.3523 - [Repealed]
- Section 500.3525 - Proposal to revise contract or rate; approval of commissioner; approval with modifications; hearing; disposition; exception; notice
- Section 500.3527 - [Repealed]
- Section 500.3528 - Health maintenance organization; credentialing verification; accreditation by nationally recognized accredited body
- Section 500.3529 - Affiliated provider contracts; collection of payments from enrollees; contract provisions; waiver of requirement under subsection (2); contract format; evidence of sufficient number of providers
- Section 500.3530 - Availability of covered services; assurance; establishment and maintenance of proximity
- Section 500.3531 - Contracts with health care providers to become affiliated providers; requirements; standards; filing; duplicative standards; notice procedures; provider application period; approval or rejection as affiliated provider; termination of contract; providing information to insurer
- Section 500.3533 - Prudent purchaser contracts; reimbursement for unauthorized services or services by nonaffiliated providers
- Section 500.3535 - Solicitation or advertising
- Section 500.3537 - [Repealed]
- Section 500.3539 - [Repealed]
- Section 500.3541 - [Repealed]
- Section 500.3542 - [Repealed]
- Section 500.3543 - [Repealed]
- Section 500.3544 - Noninsured benefit plan; processing and payment of claims
- Section 500.3545 - Acquisition of obligations from another managed care entity
- Section 500.3547 - Health care service operations; visitation or examination by director; consultation with enrollees; authority; access to information relating to delivery of services; submission of information regarding proposed contract
- Section 500.3548 - Maintenance of books, records, files, and financial records; funds and assets
- Section 500.3549 - [Repealed]
- Section 500.3551 - Health maintenance organization; net worth
- Section 500.3553 - Certificate of authority; deposit requirements
- Section 500.3555 - Financial plan
- Section 500.3557 - Notice of changes in operations
- Section 500.3559 - Reinsurance contract or plan of self-insurance; purpose; filing; approval; coverage
- Section 500.3561 - Insolvency; continuation of benefits
- Section 500.3563 - Insolvency; offer of enrollment by health insurers participating in enrollment process; allocation of group coverage to health maintenance organizations or insurers within service area; nongroup coverage; reassignment of enrollees of insolvent organization contracting with state funded health care program; substitute coverage under American health benefit exchange
- Section 500.3565 - [Repealed]
- Section 500.3567 - [Repealed]
- Section 500.3569 - Assumption of financial risk
- Section 500.3571 - State or federal health programs
- Section 500.3573 - Operation of health care delivery system not meeting requirements of act; permitted conduct; limitations
- Section 500.3580 - [Repealed]