2009 Iowa Code
Title 13 - Commerce
Subtitle 1 - Insurance and Related Regulation
CHAPTER 514B - HEALTH MAINTENANCE ORGANIZATIONS
514B.4 - APPLICANT FOR CERTIFICATE OF AUTHORITY.

        514B.4  APPLICANT FOR CERTIFICATE OF AUTHORITY.
         The commissioner shall determine whether the applicant for a
      certificate of authority, with respect to health care services to be
      furnished:
         1.  Has demonstrated the willingness and potential ability to
      assure the availability, accessibility, and continuity of service
      through adequate personnel and facilities.
         2.  Has arrangements established in accordance with rules adopted
      by the commissioner for a continuous review of health care processes
      and outcomes.  If a health maintenance organization is accredited by
      the national committee on quality assurance, or another accreditation
      entity approved by the commissioner, an external peer review under
      rules of the commissioner shall not be applicable.  However, at the
      discretion of the commissioner, an on-site inspection of the health
      maintenance organization may be conducted.
         3.  Has a procedure established in accordance with rules adopted
      by the commissioner to develop, compile, evaluate, and report
      statistics relating to the cost of its operations, the pattern of
      utilization of its services, the availability and accessibility of
      its services, and other matters as may be reasonably required by the
      commissioner.
         The commissioner, in administering this section and sections
      514B.25 and 514B.26, may contract with qualified persons to make
      recommendations concerning the determinations required to be made by
      the commissioner.  Such recommendations may be accepted in full or in
      part by the commissioner.  

         Section History: Early Form

         [C75, 77, 79, 81, § 514B.4] 

         Section History: Recent Form

         92 Acts, ch 1162, § 21; 99 Acts, ch 165, § 11
         Referred to in § 514B.3, 514B.5