CHAPTER 432D

HEALTH MAINTENANCE ORGANIZATION ACT

Section

    432D-1 Definitions

  432D-1.5 Bona fide trade associations

    432D-2 Establishment of health maintenance organizations

    432D-3 Powers of health maintenance organizations

    432D-4 Fiduciary responsibilities

    432D-5 Annual and quarterly reports

    432D-6 Information to enrollees or subscribers

    432D-7 Investments

    432D-8 Protection against insolvency

    432D-9 Uncovered expenditures insolvency deposit

  432D-9.5 Reserve credit for reinsurance

   432D-10 Enrollment period

   432D-11 Replacement coverage

   432D-12 Powers of insurers and hospital and medical service

           corporations

   432D-13 Examinations

   432D-14 Suspension, revocation, or denial of certificate of

           authority

   432D-15 Rehabilitation, liquidation, or conservation of

           health maintenance organizations

   432D-16 Summary orders and supervision

   432D-17 Fees

   432D-18 Penalties and enforcement

 432D-18.5 Repealed

   432D-19 Statutory construction and relationship to other laws

   432D-20 Filings and reports as public documents

   432D-21 Confidentiality of medical information

   432D-22 Acquisition of control of or merger of a health

           maintenance organization

   432D-23 Required provisions and benefits

 432D-23.5 Coverage for telehealth

 432D-23.6 Federally funded programs; exemption

   432D-24 Coordination of benefits

   432D-25 Disclosure of health care coverage and benefits

   432D-26 Genetic information nondiscrimination in health

           insurance coverage

 432D-26.3 Nondiscrimination on the basis of actual gender

           identity or perceived gender identity; coverage for

           services

   432D-27 Policies relating to domestic abuse cases

   432D-28 Federal law compliance

   432D-29 Prohibition on rescissions of coverage

   432D-30 Medication synchronization; proration; dispensing

           fees

   432D-31 Extension of dependent coverage

   432D-32 Prohibition of preexisting condition exclusions

   432D-33 Prohibited discrimination in premiums or

           contributions

Cross References

  Assessments of health insurers, see §431:2-216.

  Conformance to federal law, see §431:2-201.5.

  Peer review, see §663-1.7.

  Prescription drug benefits, see chapter 431R.

  Prescription drugs; mail order opt out option, see §87A-16.3.

Attorney General Opinions

  Section 431:10A-601 applied only to insurers, and not mutual benefit societies or health maintenance organizations.  Att. Gen. Op. 97-5.

Case Notes

  As this chapter does not cover the field of managed care regulation and because §§432D-2, 432E-1, and article 431:10A can be read together and there is no explicit language or policy reason not to give each statute effect, this chapter does not repeal chapter 432E by implication.  126 H. 326, 271 P.3d 621 (2012).

  Properly licensed HMOs, like plaintiff, were authorized pursuant to §432D-1 to "provide or arrange", at their option, for the closed panel health care services required under the managed care plan program; accident and health insurers were authorized under §431:10A-205(b) to arrange for medical services for members using a defined network of providers, i.e., particular "hospitals or persons"; thus, article 431:10A and this chapter authorized both accident and health insurers and HMOs, as risk-bearing entities, to provide the closed panel product required by the managed care plan contracts.  126 H. 326, 271 P.3d 621 (2012).