17:48H-23 - Suspension, revocation of license, grounds
17:48H-23. Suspension, revocation of license, grounds
23. The Commissioner of Banking and Insurance may suspend or revoke the license issued to an organized delivery system pursuant to this act upon the commissioner's determination that:
a.The licensed organized delivery system is operating in contravention of its basic organizational documents;
b.The licensed organized delivery system is unable to fulfill its obligations to the carriers with whom it contracts;
c.The net worth of the licensed organized delivery system is less than that required by this act, or the licensed organized delivery system has failed to correct any deficiency in its net worth as required by the commissioner;
d.The continued operation of the licensed organized delivery system would be hazardous to the health and welfare of the enrollees or contract holders with whom it has contracted to provide health care services or detrimental to a carrier with whom it has contracted to provide the services;
e.The licensed organized delivery system has failed to file any report required pursuant to this act;
f.The licensed organized delivery system has failed to provide the health care services for which it has been licensed or has provided health care services which are in contravention of the contract or contracts filed with the commissioner;
g.The licensed organized delivery system is unable to maintain the standards set forth by regulation;
h.The licensed organized delivery system has failed, as provided by the contract, to comply with the provisions of P.L.1997, c.192 (C.26:2S-1 et seq.);
i.The licensed organized delivery system has otherwise failed to comply with this act or with other applicable law; or
j.There are other reasonable grounds that warrant suspension or revocation.
L.1999,c.409,s.23.