- A. Upon receipt of an application for issuance of a certificate of authority, the superintendent may transmit copies of such application and accompanying documents to the secretary of health.
- B. If requested by the superintendent, the secretary of health shall determine whether the applicant for a certificate of authority, with respect to health care services to be furnished, has complied with Section 59A-46-7 NMSA 1978.
- C. If requested by the superintendent, the secretary of health shall certify to the superintendent, within forty-five days of receipt of the application for issuance of a certificate of authority, that the proposed health maintenance organization meets the requirements of Section 59A-46-7 NMSA 1978 or notify the superintendent that the health maintenance organization does not meet such requirements and specify in what respects it is deficient.
D. The superintendent shall within forty-five days of receipt of certification or notice of deficiencies from the secretary of health pursuant to Subsection C of this section, or within sixty days of receipt of the application indicated in Subsection A of this section if no request has been made of the secretary of health, issue a certificate of authority to any person filing a completed application upon receiving the prescribed fees and upon the superintendent being satisfied that:
- (1) the persons responsible for the conduct of the affairs of the applicant are competent, trustworthy and possess good reputations;
- (2) any deficiencies identified by the secretary of health pursuant to Subsection C of this section have been corrected and the secretary of health has certified to the superintendent that the health maintenance organization's proposed plan of operation meets the requirements of Section 59A-46-7 NMSA 1978;
- (3) 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 or deductibles, or both; and
- (4) the health maintenance organization is in compliance with Sections 59A-46-13 and 59A-46-15 NMSA 1978 [repealed].
- E. A certificate of authority shall be denied only after the superintendent complies with the requirements of Section 59A-46-20 NMSA 1978.
History: 1978 Comp., § 59A-46-4, enacted by Laws 1993, ch. 266, § 4.
ANNOTATIONS
Bracketed material. — The bracketed material was inserted by the compiler and is not part of the law. Laws 2024, ch. 36, § 11 repealed 59A-46-15 NMSA 1978, effective January 1, 2025.
Repeals and reenactments. — Laws 1993, ch. 266, § 43 repealed former 59A-46-4 NMSA 1978, as enacted by Laws 1984, ch. 127, § 851, and Laws 1993, ch. 266, § 4 enacted a new section, effective January 1, 1994.