33-25D-1 Short title
33-25D-2 Definitions
33-25D-3 Application for certificate of authority; addition of services
33-25D-4 Conditions precedent to issuance or maintenance of a certificate of authority; renewal of certificate of authority; effect of bankruptcy proceedings
33-25D-5 Issuance of certificate of authority
33-25D-6 Minimum capital
33-25D-7 Powers of organization
33-25D-8 Governing body; enrollee participation
33-25D-9 Fiduciary responsibilities of managers; fidelity bond
33-25D-10 Provider contracts
33-25D-11 Evidence of coverage; review of enrollee records; charges for limited health services; cancellation of contract by enrollee
33-25D-12 Annual and quarterly reports
33-25D-13 Annual report to enrollees
33-25D-14 Grievance procedure
33-25D-15 Prohibited practices
33-25D-16 Agent licensing and appointment required; regulation of marketing
33-25D-17 Powers of insurers, hospital service corporations, medical service corporations, dental service corporations, health service corporations and health maintenance organizations
33-25D-18 Examinations
33-25D-19 Quality assurance
33-25D-20 Suspension or revocation of certificate of authority
33-25D-21 Rehabilitation, liquidation or conservation of prepaid limited health service organization
33-25D-22 Rules
33-25D-23 Administrative procedures
33-25D-24 Fees
33-25D-25 Penalties and enforcement
33-25D-26 Scope of provisions; applicability of other laws
33-25D-27 Filings and reports as public documents
33-25D-28 Confidentiality of medical information
33-25D-29 Authority to contract with prepaid limited health service organizations under Medicaid
33-25D-30 Authority of commissioner to propose rules regarding affiliate and subsidiary operating results

Terms Used In West Virginia Code > Chapter 33 > Article 25D - Prepaid Limited Health Service Organization Act

  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Contract: A legal written agreement that becomes binding when signed.
  • Conviction: A judgement of guilt against a criminal defendant.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Fiduciary: A trustee, executor, or administrator.
  • in writing: includes any representation of words, letters, or figures, whether by printing, engraving, writing, or otherwise. See West Virginia Code 2-2-10
  • Judgment: includes decrees and orders for the payment of money, or the conveyance or delivery of land or personal property, or some interest therein, or any undertaking, bond or recognizance which has the legal effect of a judgment. See West Virginia Code 2-2-10
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • Precedent: A court decision in an earlier case with facts and law similar to a dispute currently before a court. Precedent will ordinarily govern the decision of a later similar case, unless a party can show that it was wrongly decided or that it differed in some significant way.
  • Probable cause: A reasonable ground for belief that the offender violated a specific law.
  • Recourse: An arrangement in which a bank retains, in form or in substance, any credit risk directly or indirectly associated with an asset it has sold (in accordance with generally accepted accounting principles) that exceeds a pro rata share of the bank's claim on the asset. If a bank has no claim on an asset it has sold, then the retention of any credit risk is recourse. Source: FDIC
  • State: when applied to a part of the United States and not restricted by the context, includes the District of Columbia and the several territories, and the words "United States" also include the said district and territories. See West Virginia Code 2-2-10
  • Statute: A law passed by a legislature.