Article 46 - HEALTH MAINTENANCE ORGANIZATIONS
- Section 59A-46-1 - Short title
- Section 59A-46-2 - Definitions
- Section 59A-46-3 - Establishment of health maintenance organizations
- Section 59A-46-4 - Issuance of certificate of authority
- Section 59A-46-5 - Powers of health maintenance organizations
- Section 59A-46-6 - Fiduciary responsibilities; fidelity bond
- Section 59A-46-7 - Quality assurance program
- Section 59A-46-8 - Requirements for group contract, individual contract and evidence of coverage
- Section 59A-46-9 - Annual report
- Section 59A-46-10 - Information to enrollees or subscribers
- Section 59A-46-11 - Grievance procedures
- Section 59A-46-12 - Investments
- Section 59A-46-13 - Protection against insolvency
- Section 59A-46-14 - Uncovered expenditures insolvency deposit
- Section 59A-46-15 - [Repealed Effective 1/1/2025] Enrollment period; replacement coverage in the event of insolvency
- Section 59A-46-16 - Filing requirements for rating information
- Section 59A-46-17 - Regulation of health maintenance organization insurance producers
- Section 59A-46-18 - Powers of insurers
- Section 59A-46-19 - Examinations
- Section 59A-46-20 - Suspension or revocation of certificate of authority
- Section 59A-46-21 - Rehabilitation, liquidation or conservation of health maintenance organizations
- Section 59A-46-22 - Summary orders and supervision
- Section 59A-46-22.1 - [Repealed]
- Section 59A-46-23 - Regulations
- Section 59A-46-24 - Fees
- Section 59A-46-25 - Penalties and enforcement
- Section 59A-46-26 - Filings and reports as public documents
- Section 59A-46-26.1 - Employer utilization and loss experience availability
- Section 59A-46-27 - Confidentiality of medical information and limitation of liability
- Section 59A-46-28 - Authority to contract
- Section 59A-46-29 - Health maintenance organizations; contract or certificate provisions relating to individuals who are eligible for medical benefits under the medicaid program
- Section 59A-46-30 - Statutory construction and relationship to other laws
- Section 59A-46-31 - Coordination of benefits
- Section 59A-46-32 - Continuation of coverage and conversion rights; health care plans
- Section 59A-46-32.1 - Recompiled
- Section 59A-46-33 - Governing body
- Section 59A-46-34 - Prohibited practices
- Section 59A-46-35 - Provider discrimination prohibited
- Section 59A-46-36 - Doctor of oriental medicine; discrimination prohibited
- Section 59A-46-37 - Coverage for adopted children
- Section 59A-46-38 - Newly born children coverage
- Section 59A-46-38.1 - Coverage of children
- Section 59A-46-38.2 - Childhood immunization coverage required
- Section 59A-46-38.3 - Maximum age of dependent
- Section 59A-46-38.4 - Coverage of circumcision for newborn males
- Section 59A-46-38.5 - Hearing aid coverage for children required
- Section 59A-46-39 - Maternity transport required
- Section 59A-46-40 - Home health care service option required
- Section 59A-46-41 - Coverage for mammograms
- Section 59A-46-41.1 - Mastectomies and lymph node dissection; minimum hospital stay coverage required
- Section 59A-46-41.2 - Prior authorization for gynecological or obstetrical ultrasounds prohibited
- Section 59A-46-41.3 - Diagnostic and supplemental breast examinations
- Section 59A-46-42 - Coverage for cytologic and human papillomavirus screening
- Section 59A-46-42.1 - Coverage for the human papillomavirus vaccine
- Section 59A-46-43 - Coverage for individuals with diabetes
- Section 59A-46-43.2 - Coverage for medical diets for genetic inborn errors of metabolism
- Section 59A-46-44 - Coverage for contraception
- Section 59A-46-45 - Coverage for smoking cessation treatment
- Section 59A-46-46 - Coverage of alpha-fetoprotein IV screening test
- Section 59A-46-47 - Coverage of part-time employees
- Section 59A-46-48 - Coverage of colorectal cancer screening
- Section 59A-46-49 - General anesthesia and hospitalization for dental surgery
- Section 59A-46-50 - Coverage for autism spectrum disorder diagnosis and treatment
- Section 59A-46-50.1 - Coverage for orally administered anticancer medications; limits on patient costs
- Section 59A-46-50.2 - Coverage of prescription eye drop refills
- Section 59A-46-50.3 - Coverage for telemedicine services
- Section 59A-46-50.4 - Prescription drugs; prohibited formulary changes; notice requirements
- Section 59A-46-50.5 - Heart artery calcium scan coverage
- Section 59A-46-51 - [Repealed]
- Section 59A-46-52 - Prescription drug prior authorization protocols
- Section 59A-46-52.1 - [Effective Until ninety days after adjournment] Prescription drug coverage; step therapy protocols; clinical review criteria; exceptions
- Section 59A-46-52.1 - [Effective ninety days after adjournment] Prescription drug coverage-step therapy protocols-clinical review criteria-exceptions
- Section 59A-46-52.2 - Pharmacist prescriptive authority services; reimbursement parity
- Section 59A-46-52.3 - Calculating an enrollee's cost-sharing obligation for prescription drug coverage
- Section 59A-46-53 - Pharmacy benefits; prescription synchronization
- Section 59A-46-54 - Provider credentialing; requirements; deadline
- Section 59A-46-55 - [Contingent repeal. See note below.] Coverage exclusion
- Section 59A-46-56 - Physical rehabilitation services; limits on cost sharing
- Section 59A-46-57 - Behavioral health services; elimination of cost sharing
- Section 59A-46-58 - Anatomical gift nondiscrimination
- Section 59A-46-59 - Chiropractic physician services; limits on cost sharing and coinsurance
- Section 59A-46-60 - Sexually transmitted infection care; cost sharing eliminated
- Section 59A-46-61 - Definitions
- Section 59A-46-62 - Benefits required
- Section 59A-46-63 - Parity for coverage of mental health or substance use disorder services
- Section 59A-46-64 - Provider network adequacy
- Section 59A-46-65 - Utilization review of mental health or substance use disorder services
- Section 59A-46-66 - Prohibited exclusions of coverage for mental health or substance use disorder services
- Section 59A-46-67 - Level of care determinations for the provision of mental health or substance use disorder services
- Section 59A-46-68 - Coordination of care
- Section 59A-46-69 - Confidentiality provisions
- Section 59A-46-70 - Exceptions
- Section 59A-46-71 - Biomarker testing coverage
- Section 59A-46-72 - Medical necessity and nondiscrimination standards for coverage of prosthetics and orthotics