83-41-307 - Transmission of copies of application for certificate of authority to State Health Officer; duties of State Health Officer; grant or denial of certificate of authority.
§ 83-41-307. Transmission of copies of application for certificate of authority to State Health Officer; duties of State Health Officer; grant or denial of certificate of authority.
(1) (a) Upon receipt of an application for issuance of a certificate of authority, the commissioner shall forthwith transmit copies of the application and accompanying documents to the State Health Officer.
(b) The State Health Officer shall determine whether the applicant for a certificate of authority, with respect to health care services to be furnished has complied with Section 83-41-313.
(c) Within forty-five (45) days of receipt of the application for issuance of a certificate of authority, the State Health Officer shall certify to the commissioner that the proposed health maintenance organization meets the requirements of Section 83-41-313 or notify the commissioner that the health maintenance organization does not meet the requirements and specify deficiencies.
(2) The commissioner shall within forty-five (45) days of receipt of certification or notice of deficiencies from the State Health Officer issue a certificate of authority to any person filing a completed application upon receiving the prescribed fees and upon the commissioner being satisfied that:
(a) The persons responsible for the conduct of the affairs of the applicant are competent, trustworthy and possess good reputations;
(b) Any deficiencies identified by the State Health Officer have been corrected and the State Health Officer has certified to the commissioner that the health maintenance organization's proposed plan of operation meets the requirements of Section 83-41-313 and other related regulations;
(c) The health maintenance organization will effectively provide or arrange for the provision of basic health care services on a prepaid basis, through insurance or otherwise, except to the extent of reasonable requirements for copayments and/or deductibles; and
(d) The health maintenance organization is in compliance with Sections 83-41-325 and 83-41-329.
(3) A certificate of authority shall be denied only after the commissioner complies with the requirements of Section 83-41-339.
Sources: Laws, 1995, ch. 613, § 4, eff from and after July 1, 1995.