Alaska Statutes Title 21, Chapter 21.86 - Health Maintenance Organizations

• Sec. 21.86.010 Establishment of Health Maintenance Organizations.
  (a) A person may apply to the director for and obtain a certificate of authority to establish and operate a health maintenance organization in...
• Sec. 21.86.020 Issuance of Certificate of Authority; Approval of Changes.
  (a) Within 10 days after receipt of an application for a certificate of authority, the director shall forward a copy of the application to...
• Sec. 21.86.030 Powers of a Health Maintenance Organization.
  (a) A health maintenance organization may(1) purchase, lease, construct, renovate, operate, or maintain hospitals, other health care facilities, their ancillary equipment, and property reasonably...
• Sec. 21.86.040 Governing Body; Enrollee Participation.
  (a) The governing body of a health maintenance organization may include providers, or other individuals, or both. At least one-third of the governing body...
• Sec. 21.86.045 Biographical Affidavits.
  A domestic health maintenance organization shall file with the director a complete affidavit of biographical information not later than 30 days after the appointment...
• Sec. 21.86.050 Fiduciary Responsibility.
  (a) A director, officer, employee, or partner of a health maintenance organization who receives, collects, disburses, or invests money in connection with the activities...
• Sec. 21.86.060 Provision of Services.
  (a) A health maintenance organization may provide provider services directly, through provider employees, or may provide the services under arrangements with individual providers or...
• Sec. 21.86.070 Evidence of Coverage; Charges for Health Care Services.
  (a) An enrollee residing in this state is entitled to evidence of coverage. If an enrollee obtains coverage from an insurance policy or from...
• Sec. 21.86.075 Chiropractic Health Care Services.
  (a) An enrollee may use the services of a licensed chiropractor of the enrollee's choosing and may not be required to obtain the prior...
• Sec. 21.86.078 Choice of Health Care Provider.
  (a) A health maintenance organization shall offer to every enrollee a point-of-service plan option that would allow a covered person to receive covered services...
• Sec. 21.86.080 Annual Statement; Additional Reports.
  (a) A health maintenance organization shall file an annual statement with the director under AS 21.09.200 and shall provide a copy to the commissioner...
• Sec. 21.86.087 [Renumbered As As 21.06.087 ].
  
  Repealed or Renumbered
• Sec. 21.86.090 Information to Enrollees.
  A health maintenance organization shall promptly notify its enrollees of a material change in its operation that would directly affect the enrollees.
• Sec. 21.86.100 Complaint System; Report.
  (a) A health maintenance organization shall establish and maintain a complaint system to provide reasonable procedures for the resolution of written complaints initiated by...
• Sec. 21.86.110 Recovery of Health Care Costs.
  If a health maintenance organization determines that an enrollee has received health care services that the enrollee is not entitled to receive under the...
• Sec. 21.86.120 Return of Agreement.
  A person who enters into a health maintenance agreement may return the agreement to the health maintenance organization or the agent from whom it...
• Sec. 21.86.130 Investments.
  With the exception of investments made under AS 21.86.030 , a health maintenance organization's money may only be invested as allowed by AS 21.21...
• Sec. 21.86.140 Protection Against Insolvency.
  (a) Except as otherwise provided in this section, a health maintenance organization shall deposit with the director, or with an organization or trustee acceptable...
• Sec. 21.86.150 Prohibited Practices.
  (a) A health maintenance organization or a representative of a health maintenance organization may not cause or knowingly permit a person to provide, on...
• Sec. 21.86.160 Regulation of Agents.
  (a) The director may adopt regulations necessary to provide for the licensing of health maintenance organization agents.(b) The director may, by regulation, exempt certain...
• Sec. 21.86.170 Powers of Insurers and of Hospital or Medical Service Corporations.
  (a) An insurer licensed in this state, or a hospital or medical service corporation authorized to do business in this state, may, either directly...
• Sec. 21.86.180 Examinations.
  (a) The director shall examine the affairs and transactions of a health maintenance organization in the same manner as prescribed for an insurer in...
• Sec. 21.86.190 Suspension or Revocation of Certificate of Authority.
  (a) After compliance with AS 21.86.200 , the director may suspend or revoke a certificate of authority issued to a health maintenance organization under...
• Sec. 21.86.200 Administrative Procedures.
  (a) If the director has reason to believe that grounds for the denial, suspension, or revocation of a certificate of authority exist, the director...
• Sec. 21.86.210 Rehabilitation, Liquidation, or Conservation.
  (a) A rehabilitation, liquidation, or conservation of a health maintenance organization is considered to be a rehabilitation, liquidation, or conservation of an insurer, and...
• Sec. 21.86.220 Regulations.
  The commissioner of health and social services may adopt regulations necessary to carry out the commissioner's duties under this chapter. The director may adopt...
• Sec. 21.86.230 Fees.
  (a) A health maintenance organization shall pay fees to the director as provided under AS 21.06.250 .(b) A health maintenance organization shall pay to...
• Sec. 21.86.240 Taxation.
  A health maintenance organization is taxed as provided under AS 21.09.210(b)(1), and shall file the report required of an authorized insurer under AS 21.09.210
• Sec. 21.86.250 Penalties and Enforcement.
  (a) Instead of, or in addition to, suspending or revoking a certificate of authority, the director may, in an order issued under AS 21.86.200,...
• Sec. 21.86.260 Statutory Construction and Relationship to Other Law.
  (a) Except as provided in AS 21.36, AS 21.42, AS 21.54, AS 21.56 and in this chapter, this title does not apply to a...
• Sec. 21.86.270 Filings and Reports As Public Documents.
  Except for information described in AS 21.86.100 (b)(3) and except for trade secrets, privileged, confidential commercial, or financial information as determined by the director,...
• Sec. 21.86.280 Confidentiality of Medical Information. [Repealed, Sec. 53 Ch 96 Sla 2004].
  Repealed or Renumbered
• Sec. 21.86.290 Contract Authority for Commissioner of Health and Social Services.
  In carrying out duties under this chapter, the commissioner of health and social services may contract with qualified persons to make recommendations concerning the...
• Sec. 21.86.300 Acquisition of Control or Merger of a Health Maintenance Organization.
  (a) A person may not acquire control of the voting securities of a domestic health maintenance organization, if, after the consummation of the transaction,...
• Sec. 21.86.310 Dual Choice.
  (a) An employer in this state, whether public or private, that offers its employees a health benefit plan and employs 25 or more employees...
• Sec. 21.86.900 Definitions.
  In this chapter,(1) "affiliation period" means a period of time under a contract with a health maintenance organization(A) that must expire before coverage becomes...

Last modified: November 15, 2016