S.C. Code Ann. tit. 38, ch. 33 – Health Maintenance Organizations | Midpage

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South Carolina Code of Laws

Chapter 33

S.C. Code Ann. tit. 38, ch. 33

Health Maintenance Organizations

38-33-10Short title 38-33-20Definitions 38-33-30Necessity of certificate of authority; foreign corporation 38-33-40Issuance of certificate of authority; criteria and considerations; arrangements for participation of providers in each geographic area served 38-33-50Powers of health maintenance organization; notice prior to exercise of powers 38-33-60Members of governing body; advisory panels, etc 38-33-70Fiduciary relationship in handling of funds 38-33-80Enrollee entitled to evidence of coverage; contents of evidence of coverage; discontinuance or replacement of coverage; charges for services 38-33-90Statements and reports 38-33-100Financial requirements before issuance of certificate of authority to health maintenance organization 38-33-110Complaint procedures; reports; malpractice claims; applicability of Freedom of Information Act 38-33-120Investment of funds 38-33-130Security deposit; individual stop-loss coverage; provisions for unpaid claim liability; individual conversion policy 38-33-140Advertisements; application of provisions relating to trade practices; use of term "insurer" or "health maintenance organization"38-33-150Agent for organization; exemption from licensing requirements 38-33-160Operation of health maintenance organization by insurance company; contracts for cost of care 38-33-170Examination of affairs of organization; quality of health care services; books and records; expense of examination; reports 38-33-180Suspension or revocation of certificate of authority 38-33-190Rehabilitation, liquidation, or conservation of a health maintenance organization; priorities 38-33-200Implementation of regulations 38-33-210Notification of grounds for denial, suspension or revocation of certificate of authority; hearings; judicial review 38-33-220Fees 38-33-230Levy of administrative penalty in lieu of revocation or suspension of certificate of authority; monetary penalty; notice and hearings; injunctions 38-33-240Application of provisions of insurance law or law relating to solicitation or advertising by health professionals; practice of medicine, dentistry or other healing profession 38-33-250Records of organization as public documents; trade secrets, etc 38-33-260Confidentiality of health records 38-33-270Contractual powers of Department to assist in investigative duties; assessments for consulting expenses 38-33-280Acquisition or exchange of securities of a health maintenance organization; merger or consolidation of HMO 38-33-290Participation by physician, podiatrist, optometrist, or oral surgeon as provided in HMO 38-33-300Liability for participation in quality of care or utilization review 38-33-310HMO may contract with out-of-state provider 38-33-325Obstetrician-gynecologist services; referrals; authorization for services; member notification of plan provisions