Current through Pa Acts 2024-53, 2024-56 through 2024-92
Section 1561 - Reports and examinations(a) The health maintenance organization shall, on or before the first of March of every year, file with the commissioner a statement verified by at least two of the principal officers of the health maintenance organization summarizing its financial activities during the calendar or fiscal year immediately preceding, and showing its financial condition at the close of business on December 31 of that year, or the health maintenance organization's fiscal year. Such statement shall be in such form and shall contain such matter as the commissioner prescribes. The financial affairs and status of every health maintenance organization shall be examined by the commissioner or his agents not less frequently than once in every three years and for this purpose the commissioner and his agents shall be entitled to the aid and cooperation of the officers and employes of the health maintenance organization and shall have convenient access to all books, records, papers, and documents that relate to the financial affairs of the health maintenance organization. They shall have authority to examine under oath or affirmation the officers, agents, employes and subscribers for the health services of the health maintenance organization, and all other persons having or having had substantial part in the work of the health maintenance organization in relation to its affairs, transactions and financial condition. The Insurance Commissioner may at any time, without making such examination, call on a health maintenance organization for a written report authenticated by at least two of its principal officers concerning the financial affairs and status of the health maintenance organization.(b) A health maintenance organization shall maintain its financial records in such manner that the revenues and expenses associated with the establishment, maintenance and operation of its prepaid health care delivery system under this act are identifiable and distinct from other activities it may engage in which are not directly related to the establishment, maintenance and operation of its prepaid health care delivery system under this act.(c) The secretary or his agents shall have free access to all the books, records, papers and documents that relate to the business of the health maintenance organization, other than financial.Amended by P.L. 870 2014 No. 96, § 3, eff. 8/31/2014.1972, Dec. 29, P.L. 1701, No. 364, § 11, imd. effective. Amended 1980, Dec. 19, P.L. 1300, No. 234, § 4, effective in 60 days.