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26.1-07.1 Jurisdiction Over Providers of Health Care Benefits

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CHAPTER 26.1-07.1JURISDICTION OVER PROVIDERS OF HEALTH CARE BENEFITS26.1-07.1-01. Jurisdiction over providers of health care benefits. Notwithstandingany other provision of law, and except as provided herein, any person or other entity, other than<br>an insurance company duly licensed in this or another state which provides coverage in this state<br>for medical, surgical, chiropractic, physical therapy, speech pathology, audiology, professional<br>mental health, dental, hospital, or optometric expenses, whether such coverage is by direct<br>payment, reimbursement, or otherwise, must be presumed to be subject to the jurisdiction of the<br>commissioner unless the person or other entity shows that while providing such services it is<br>subject to the jurisdiction of another agency of this state, any subdivisions thereof, or the federal<br>government.26.1-07.1-02. How to show jurisdiction. A person or entity may show that it is subjectto the jurisdiction of another agency of this state, any subdivision thereof, or the federal<br>government by providing to the commissioner the appropriate certificate, license, or other<br>document issued by the other governmental agency which permits or qualifies it to provide those<br>services.26.1-07.1-03.Examination.Any person or entity which is unable to show that it issubject to the jurisdiction of another agency of this state, any subdivision thereof, or the federal<br>government shall submit to an examination by the commissioner to determine the organization<br>and solvency of the person or the entity, and to determine whether or not such person or entity is<br>in compliance with the applicable provisions of state law.26.1-07.1-04. Subject to state laws. Any person or entity unable to show that it issubject to the jurisdiction of another agency of this state, any subdivision thereof, or the federal<br>government is subject to all appropriate provisions of state law regarding the conduct of its<br>business.26.1-07.1-05. Disclosure. Any production agency or administrator which advertises,sells, transacts, or administers coverage in this state described in section 26.1-07.1-01 which is<br>provided by any person or entity described in section 26.1-07.1-03 shall, if that coverage is not<br>fully insured or otherwise fully covered by an admitted life or disability insurer, nonprofit hospital<br>service plan, or nonprofit health care plan, advise any purchaser, prospective purchaser, and<br>covered person of such lack of insurance or other coverage.Any administrator which advertises or administers coverage in this state, described insection 26.1-07.1-01, which is provided by any person or entity described in section 26.1-07.1-03,<br>shall advise any production agency of the elements of the coverage, including the amount of<br>&quot;stop-loss&quot; insurance in effect.Page No. 1Document Outlinechapter 26.1-07.1 jurisdiction over providers of health care benefits