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Health Maintenance Organizations
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Health Maintenance Organizations
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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
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Repealed.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-46-42
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
Coverage for individuals with diabetes. (Effective January 1, 2021.)
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
Health maintenance organizations; direct services.
Section
59A-46-52
Prescription drug prior authorization protocols.
Section
59A-46-52.1
Prescription drug coverage; step therapy protocols; clinical review criteria; exceptions.
Section
59A-46-52.2
Pharmacist prescriptive authority services; reimbursement parity.
Section
59A-46-53
Pharmacy benefits; prescription synchronization.
Section
59A-46-54
Provider credentialing; requirements; deadline.
Section
59A-46-55
Coverage exclusion. (Contingent repeal. See note below.)
Section
59A-46-56
Physical rehabilitation services; limits on cost sharing.