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South Dakota Laws > Title 58 > Chapter 41 - Health Maintenance Organizations

South Dakota Laws > Title 58 > Chapter 41 - Health Maintenance Organizations


Current as of: 2010
§ 58-41-1Definition of terms
§ 58-41-2Organizations subject to chapter
§ 58-41-3Certificate of authority required for health maintenance organization or contracts--Violation as misdemeanor
§ 58-41-4Application for certificate of authority required
§ 58-41-6Verification and form of application--Contents
§ 58-41-7Financial statements required with application
§ 58-41-8Copies of forms required with application
§ 58-41-9Marketing, charges, and financial plans required with application
§ 58-41-10Appointment to receive process required of foreign applicant
§ 58-41-11Surety bond or deposit required--Waiver
§ 58-41-12Transmittal of application to secretary of health--Determination of health care qualifications
§ 58-41-13Coordination with federal professional standards review
§ 58-41-15Health maintenance not considered practice of healing arts
§ 58-41-15.1Certain healing arts practitioners to participate in alternate health care delivery systems
§ 58-41-16Certification as to meeting health care requirements--Deficiencies specified
§ 58-41-17Time for issuance or denial of certificate--Fee--Conditions for issuance
§ 58-41-18Factors considered in determining financial responsibility
§ 58-41-19Insurance arrangements permitted
§ 58-41-20Corporation operating after certification
§ 58-41-21Foreign corporations qualifying--Exemption from other requirements
§ 58-41-22Filing of notice of modification of operation--Approval if not disapproved--Exemptions
§ 58-41-23Composition of governing body--Required consumer representation
§ 58-41-24Mechanisms for enrollee participation in policy and operation of governing body
§ 58-41-25Fiduciary responsibilities to enrollees
§ 58-41-25.1Investments
§ 58-41-26Exemption from insurance laws--Taxation
§ 58-41-28Solicitation of enrollment not deemed professional advertising
§ 58-41-29Contracts and necessary activities
§ 58-41-29.1Notice required for rate increase in health maintenance contract by a health maintenance organization
§ 58-41-30Sources of payment for enrollee services--Application by medical assistance recipient
§ 58-41-32Use of words descriptive of insurance, casualty, or surety business as misdemeanor--Exception
§ 58-41-33Trade practice laws applicable
§ 58-41-34Evidence of coverage issued to enrollees
§ 58-41-35Contents required in evidence of coverage
§ 58-41-35.1Alcoholism coverage to be offered at time contract is negotiated
§ 58-41-35.5Health maintenance contracts required to cover low-dose mammography--Extent of coverage
§ 58-41-35.6Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony
§ 58-41-36Unfair and misleading information in evidence of coverage as misdemeanor
§ 58-41-37Deceptive advertising or evidence of coverage as misdemeanor
§ 58-41-38Statements deemed untrue
§ 58-41-39Statements deemed misleading
§ 58-41-40Evidence of coverage deemed deceptive
§ 58-41-41Issuance to enrollees of change in evidence of coverage
§ 58-41-42Evidence of coverage to be approved before use--Violation as misdemeanor
§ 58-41-43Filing and approval requirements applicable
§ 58-41-44Charges to enrollees--Fairness--Actuary's certificate
§ 58-41-45Discrimination as misdemeanor
§ 58-41-46Filing and approval of schedule of charges required--Exception for employer sponsored plan
§ 58-41-47Approval of forms and schedules--Time
§ 58-41-48Notice of disapproval of filing--Request for hearing
§ 58-41-49Information required by director
§ 58-41-50Authorized expenses
§ 58-41-51Cancellation or nonrenewal of coverage--Grounds--Notice--Violation as misdemeanor
§ 58-41-51.1Individual policy required for covered spouse of insured--Eligibility--Coverage--Waiting periods
§ 58-41-51.2Conversion privileges of insured's spouse upon divorce
§ 58-41-51.3Continuation and conversion coverage to be offered
§ 58-41-52Contracts with providers of health care services
§ 58-41-54Contracts with insurance companies and nonprofit health service plan corporations authorized--Limitations
§ 58-41-55Insurance contracts authorized--Group coverage--Benefit payments
§ 58-41-56Contracts for management and administrative services authorized
§ 58-41-57Payment of unreasonably high expenses as misdemeanor
§ 58-41-63General annual report required--Form and contents
§ 58-41-65Applications, filings and reports as public documents
§ 58-41-66Annual summary for enrollees required--Contents
§ 58-41-67Rules--Minimum services and permissible exclusions
§ 58-41-68Periodic examination of activities
§ 58-41-69Examination of finances and provider agreements--Minimum frequency
§ 58-41-70Examination of health care services--Minimum frequency
§ 58-41-71Investigative powers of director and secretary
§ 58-41-72Administration of oaths--Subpoena power
§ 58-41-73Physician-patient privileges
§ 58-41-74Confidential data--Exceptions
§ 58-41-75Assessment of examination expense
§ 58-41-76Examination report from another state
§ 58-41-78Cease and desist orders
§ 58-41-79Hearing on cease and desist order--Procedure--Judicial review
§ 58-41-80Injunctive relief against violations--Venue
§ 58-41-81Suspension or revocation of certificate of authority on findings by director
§ 58-41-82Suspension or revocation on grounds certified by secretary of health
§ 58-41-83Voluntary conference before commencing actions for violation
§ 58-41-84Informality in voluntary conferences
§ 58-41-85Money penalty in lieu of suspension or revocation
§ 58-41-86Requirements for suspension or revocation
§ 58-41-86.1Suspension without notice or hearing
§ 58-41-87Notice of grounds for denial, suspension, or revocation of certificate--Time of hearing--Summary proceedings excepted
§ 58-41-88Administrative procedure and rules
§ 58-41-89Participation of health department in hearings--Findings on health care conclusive
§ 58-41-90Action of directors after hearing--Written findings
§ 58-41-91Judicial review--Power of court
§ 58-41-92Activities prohibited during suspension of certificate
§ 58-41-93Winding up after revocation of certificate--Continued operation to protect enrollees
§ 58-41-94Summary proceeding to reorganize organization--Grounds
§ 58-41-95Rehabilitation, liquidation, or conservation under insurance company laws
§ 58-41-96Severability of provisions
§ 58-41-97Citation of chapter
§ 58-41-98Coverage for phenylketonuria
§ 58-41-99Formation of voluntary health insurance purchasing organizations
§ 58-41-100Membership of voluntary health insurance purchasing organizations
§ 58-41-101Purchasing organization's responsibility for negotiating terms and conditions
§ 58-41-102Purchasing organization's notice of premium charge
§ 58-41-103Additional chapters applicable to purchasing organization
§ 58-41-104Approval of purchasing organization by Division of Insurance
§ 58-41-105Premiums held in trust by purchasing organization
§ 58-41-106Rates for group health insurance issued to purchasing organizations
§ 58-41-107Reasonable participation requirements for group members of purchasing organizations
§ 58-41-108Purchasing organizations exempt from antitrust provisions
§ 58-41-109Promulgation of rules for purchasing organizations
§ 58-41-111Application of chapter to provider contracting with licensed health maintenance organization
§ 58-41-112Minimum inpatient care coverage following delivery
§ 58-41-113Shorter hospital stay permitted--Follow-up visit within forty-eight hours required
§ 58-41-114Notice to enrollees--Disclosures
§ 58-41-115Health insurance policies to provide coverage for biologically-based mental illnesses
§ 58-41-116Application--Exemptions
§ 58-41-117Policies to provide coverage for diabetes supplies, equipment, and education--Exceptions--Conditions and limitations
§ 58-41-118Diabetes coverage not required of certain plans and policies
§ 58-41-119Contracts to provide coverage for prostate cancer screening

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U.S. Code Provisions: Health Maintenance Organizations (HMOs)

U.S. Code Title 42 > Chapter 6A > Subchapter XI - Health Maintenance Organizations
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