Chapter 432D
Health Maintenance Organization Act
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432D-18.5 Repealed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
Cross References
Assessments of health insurers, see §431:2-216.
Conformance to federal law, see §431:2-201.5.
Health care provider network adequacy, see chapter 432F.
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).