Louisiana Revised Statutes 22:638 – Hearings
Terms Used In Louisiana Revised Statutes 22:638
- Adjusted risk-based capital report: means a risk-based capital report which has been adjusted by the commissioner in accordance with La. See Louisiana Revised Statutes 22:631
- Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:631
- Corrective order: means an order issued by the commissioner specifying corrective actions which the commissioner has determined are required. See Louisiana Revised Statutes 22:631
- Health organization: means a health maintenance organization licensed under Subpart I of Part I of this Chapter, a limited health service organization which bears risk, dental or vision plan which bears risk, hospital, medical and dental indemnity or service corporation which bears risk, provider-sponsored organization which bears risk, or other risk-bearing managed care organization licensed under this Title. See Louisiana Revised Statutes 22:631
- Risk-based capital plan: means a comprehensive financial plan containing the elements specified in La. See Louisiana Revised Statutes 22:631
Upon the occurrence of any of the following events, the health organization shall have the right to demand a hearing in accordance with Chapter 12 of this Title, La. Rev. Stat. 22:2191 et seq. The events include:
(1) Notification to a health organization by the commissioner of an adjusted risk-based capital report.
(2) Notification to a health organization by the commissioner that both of the following apply:
(a) The health organization’s risk-based capital plan or revised risk-based capital plan is unsatisfactory.
(b) Notification constitutes a regulatory-action level event with respect to the health organization.
(3) Notification to a health organization by the commissioner that the health organization has failed to adhere to its risk-based capital plan or revised risk-based capital plan and that the failure has a substantial adverse effect on the ability of the health organization to eliminate the company-action level event with respect to the health organization in accordance with its risk-based capital plan or revised risk-based capital plan.
(4) Notification to a health organization by the commissioner of a corrective order with respect to the health organization.
Acts 2003, No. 1106, §1, eff. Dec. 31, 2003; Redesignated from La. Rev. Stat. 22:2036.8 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2009, No. 317, §1; Acts 2009, No. 503, §1.
NOTE: Former La. Rev. Stat. 22:638 redesignated as La. Rev. Stat. 22:886 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.