Article 25A - HEALTH MAINTENANCE ORGANIZATION ACT

Section 33-25A-1 - Short title and purpose
Section 33-25A-2 - Definitions
Section 33-25A-3 - Application for certificate of authority
Section 33-25A-3a - Conditions precedent to issuance or maintenance of a certificate of authority; renewal of certificate of authority; effect of bankruptcy proceedings
Section 33-25A-4 - Issuance of certificate of authority
Section 33-25A-5 - Powers of health maintenance organizations
Section 33-25A-6 - Governing body
Section 33-25A-7 - Fiduciary responsibilities of officers; fidelity bond; approval of contracts by commissioner
Section 33-25A-7a - Provider contracts
Section 33-25A-7b - Loss ratio
Section 33-25A-8 - Evidence of coverage; charges for health care services; review of enrollee records; cancellation of contract by enrollee
Section 33-25A-8a - Third party reimbursement for mammography, pap smear or human papilloma virus testing
Section 33-25A-8b - Third party reimbursement for rehabilitation services
Section 33-25A-8c - Third party payment for child immunization services
Section 33-25A-8d - Coverage of emergency services
Section 33-25A-8e - Third party reimbursement for colorectal cancer examination and laboratory testing
Section 33-25A-8f - Required coverage for reconstruction surgery following mastectomies
Section 33-25A-8g - Required use of mail-order pharmacy prohibited
Section 33-25A-8h - Third-party reimbursement for kidney disease screening
Section 33-25A-8i - Third-party reimbursement for dental anesthesia services
Section 33-25A-8j - Coverage for diagnosis and treatment of autism spectrum disorders
Section 33-25A-8k - Maternity coverage
Section 33-25A-8l - Deductibles, copayments and coinsurance for anti-cancer medications
Section 33-25A-8m - Eye drop prescription refills
Section 33-25A-8n - Deductibles, copayments and coinsurance for abuse-deterrent opioid analgesic drugs
Section 33-25A-8o - Step therapy
Section 33-25A-8p - Lyme disease to be covered by all health insurance policies
Section 33-25A-8q - Coverage for amino acid-based formulas
Section 33-25A-8r - Substance use disorder
Section 33-25A-8s - Prior authorization
Section 33-25A-8t - Fairness in Cost-Sharing Calculation
Section 33-25A-8u - Incorporation of the Health Benefit Plan Network Access and Adequacy Act.
Section 33-25A-8v - Incorporation of the coverage for 12-month refill for contraceptive drugs
Section 33-25A-8w - Mental health parity
Section 33-25A-8x - Copayments for certain services
Section 33-25A-8y - Coverage of emergency medical services to triage and transport to alternative destination or treat in place
Section 33-25A-9 - Annual report
Section 33-25A-10 - Information to enrollees
Section 33-25A-11 - Open enrollment period
Section 33-25A-12 - Grievance procedure
Section 33-25A-13 - Investments
Section 33-25A-14 - Prohibited advertising practices
Section 33-25A-14a - Other prohibited practices
Section 33-25A-15 - Agent licensing and appointment required; regulation of marketing
Section 33-25A-16 - Powers of insurers and hospital and medical service corporations
Section 33-25A-17 - Examinations
Section 33-25A-17a - Quality assurance
Section 33-25A-18 - Suspension or revocation of certificate of authority
Section 33-25A-19 - Rehabilitation, liquidation or conservation of health maintenance organization
Section 33-25A-20 - Regulations
Section 33-25A-21 - Administrative procedures
Section 33-25A-22 - Fees
Section 33-25A-23 - Penalties and enforcement
Section 33-25A-23a - Civil penalty imposed by commissioner
Section 33-25A-24 - Scope of provisions; applicability of other laws
Section 33-25A-24a - Repealed
Section 33-25A-24b - Repealed
Section 33-25A-25 - Filings and reports as public documents
Section 33-25A-26 - Confidentiality of medical information
Section 33-25A-27 - Authority to contract with health maintenance organizations under Medicaid
Section 33-25A-28 - Required health maintenance organization option
Section 33-25A-29 - Repealed
Section 33-25A-30 - Repealed
Section 33-25A-31 - Policies discriminating among health care providers
Section 33-25A-32 - Authority of commissioner to promulgate rules and regulations regarding affiliate and subsidiary operating results
Section 33-25A-33 - Guaranty fund
Section 33-25A-34 - Ambulance services
Section 33-25A-35 - [Repealed]
Section 33-25A-36 - Assignment of certain benefits in dental care insurance coverage