Health Maintenance Organizations

  1. Law
  2. South Carolina Code of Laws
  3. Insurance
  4. Health Maintenance Organizations

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Section
38-33-10

Short title.

Section
38-33-20

Definitions.

Section
38-33-30

Necessity of certificate of authority; foreign corporation.

Section
38-33-40

Issuance of certificate of authority; criteria and considerations; arrangements for participation of providers in each geographic area served.

Section
38-33-50

Powers of health maintenance organization; notice prior to exercise of powers.

Section
38-33-60

Members of governing body; advisory panels, etc.

Section
38-33-70

Fiduciary relationship in handling of funds.

Section
38-33-80

Enrollee entitled to evidence of coverage; contents of evidence of coverage; discontinuance or replacement of coverage; charges for services.

Section
38-33-90

Statements and reports.

Section
38-33-100

Financial requirements before issuance of certificate of authority to health maintenance organization.

Section
38-33-110

Complaint procedures; reports; malpractice claims; applicability of Freedom of Information Act.

Section
38-33-120

Investment of funds.

Section
38-33-130

Security deposit; individual stop-loss coverage; provisions for unpaid claim liability; individual conversion policy.

Section
38-33-140

Advertisements; application of provisions relating to trade practices; use of term "insurer" or "health maintenance organization".

Section
38-33-150

Agent for organization; exemption from licensing requirements.

Section
38-33-160

Operation of health maintenance organization by insurance company; contracts for cost of care.

Section
38-33-170

Examination of affairs of organization; quality of health care services; books and records; expense of examination; reports.

Section
38-33-180

Suspension or revocation of certificate of authority.

Section
38-33-190

Rehabilitation, liquidation, or conservation of a health maintenance organization; priorities.

Section
38-33-200

Implementation of regulations.

Section
38-33-210

Notification of grounds for denial, suspension or revocation of certificate of authority; hearings; judicial review.

Section
38-33-220

Fees.

Section
38-33-230

Levy of administrative penalty in lieu of revocation or suspension of certificate of authority; monetary penalty; notice and hearings; injunctions.

Section
38-33-240

Application of provisions of insurance law or law relating to solicitation or advertising by health professionals; practice of medicine, dentistry or other healing profession.

Section
38-33-250

Records of organization as public documents; trade secrets, etc.

Section
38-33-260

Confidentiality of health records.

Section
38-33-270

Contractual powers of Department to assist in investigative duties; assessments for consulting expenses.

Section
38-33-280

Acquisition or exchange of securities of a health maintenance organization; merger or consolidation of HMO.

Section
38-33-290

Participation by physician, podiatrist, optometrist, or oral surgeon as provided in HMO.

Section
38-33-300

Liability for participation in quality of care or utilization review.

Section
38-33-310

HMO may contract with out-of-state provider.

Section
38-33-325

Obstetrician-gynecologist services; referrals; authorization for services; member notification of plan provisions.