Title 33, Chapter 21, Section 8
( 33-21-8)
(a) The powers of a health maintenance organization include, but are
not limited to, the following: (1) The purchase, lease, construction, renovation, operation, or
maintenance of hospitals, medical facilities, or both, their
ancillary equipment, and such property as may reasonably be
required for the organization's principal office or for such other
purposes as may be necessary in the transaction of the business of
the organization; (2) The making of loans to a medical group under contract with it
in furtherance of its program or the making of loans to a
corporation or corporations under its control for the purpose of
acquiring or constructing medical facilities and hospitals or in
furtherance of a program providing health care services to
enrollees; (3) The furnishing of health care services through providers which
are under contract with or employed by the organization; (4) The contracting with any person for the performance on its
behalf of certain functions such as marketing and enrollment; (5) The contracting with another insurer licensed in this state
for the provision of insurance, indemnity, or reimbursement
against the cost of health care services provided by the
organization; and (6) The offering, in addition to basic health care services, of: (A) Additional health care services; (B) Indemnity benefits covering out-of-area or emergency
services; and (C) Indemnity benefits, in addition to those relating to
out-of-area and emergency services, provided through insurers. (b)(1) A health maintenance organization shall file notice, with
adequate supporting information, with the Commissioner prior to
the exercise of any power granted in paragraph (1) or (2) of
subsection (a) of this Code section. The Commissioner shall
disapprove the exercise of power if in his opinion it would
substantially and adversely affect the financial soundness of the
health maintenance organization and endanger its ability to meet
its obligations. If the Commissioner does not disapprove within 90
days of the filing, it shall be deemed approved. (2) The Commissioner may promulgate rules and regulations
exempting from the filing requirement of paragraph (1) of this
subsection those activities having a de minimis effect. |