(a) A care management organization shall be required to obtain a certificate of authority as a health maintenance organization pursuant to Chapter 21 of this title prior to providing or arranging health care for members pursuant to a contract with the Department of Community Health. On and after the date of issuance of its certificate of authority as a health maintenance organization, a care management organization shall comply with all provisions relating to health maintenance organizations and all provisions relating to managed health care plans, with the exception of Code Section 33-20A-9.1.
(b) The Commissioner of Insurance shall not have the authority to approve, disapprove, or set rates paid by the Department of Community Health to a care management organization or paid by a care management organization to a health care provider.
(c) The Commissioner of Insurance shall not have the authority to approve, disapprove, or modify any plan offered by a care management organization or any contract between a care management organization and the Department of Community Health.
(d) Nothing in this chapter shall be interpreted as altering the authority of the commissioner of community health.
Section: Previous 33-21a-1 33-21a-2 33-21a-3 33-21a-4 33-21a-5 33-21a-6 33-21a-7 33-21a-8 33-21a-9 33-21a-10 33-21a-11 33-21a-12 NextLast modified: October 14, 2016