South Dakota 41 — Health Maintenance Organizations
- 58-41-1 — Definition of terms.
- 58-41-2 — Organizations subject to chapter.
- 58-41-3 — Certificate of authority required for health maintenance organization orcontracts--Violation as misdemeanor.
- 58-41-4 — Application for certificate of authority required.
- 58-41-5 — Repealed.
- 58-41-6 — Verification and form of application--Contents.
- 58-41-7 — Financial statements required with application.
- 58-41-8 — Copies of forms required with application.
- 58-41-9 — Marketing, charges, and financial plans required with application.
- 58-41-10 — Appointment to receive process required of foreign applicant.
- 58-41-11 — Surety bond or deposit required--Waiver.
- 58-41-12 — Transmittal of application to secretary of health--Determination of healthcare qualifications.
- 58-41-13 — Coordination with federal professional standards review.
- 58-41-14 — Obsolete.
- 58-41-15 — Health maintenance not considered practice of healing arts.
- 58-41-15.1 — Certain healing arts practitioners to participate in alternate health caredelivery systems.
- 58-41-16 — Certification as to meeting health care requirements--Deficienciesspecified.
- 58-41-17 — Time for issuance or denial of certificate--Fee--Conditions for issuance.
- 58-41-18 — Factors considered in determining financial responsibility.
- 58-41-19 — Insurance arrangements permitted.
- 58-41-20 — Corporation operating after certification.
- 58-41-21 — Foreign corporations qualifying--Exemption from other requirements.
- 58-41-22 — Filing of notice of modification of operation--Approval if notdisapproved--Exemptions.
- 58-41-23 — Composition of governing body--Required consumer representation.
- 58-41-24 — Mechanisms for enrollee participation in policy and operation ofgoverning body.
- 58-41-25 — Fiduciary responsibilities to enrollees.
- 58-41-25.1 — Investments.
- 58-41-26 — Exemption from insurance laws--Taxation.
- 58-41-27 — Repealed.
- 58-41-28 — Solicitation of enrollment not deemed professional advertising.
- 58-41-29 — Contracts and necessary activities.
- 58-41-29.1 — Notice required for rate increase in health maintenance contract by ahealth maintenance organization.
- 58-41-30 — Sources of payment for enrollee services--Application by medicalassistance recipient.
- 58-41-31 — Direct payments to enrollees prohibited.
- 58-41-32 — Use of words descriptive of insurance, casualty, or surety business asmisdemeanor--Exception.
- 58-41-33 — Trade practice laws applicable.
- 58-41-34 — Evidence of coverage issued to enrollees.
- 58-41-35 — Contents required in evidence of coverage.
- 58-41-35.1 — Alcoholism coverage to be offered at time contract is negotiated.
- 58-41-35.2 — Repealed.
- 58-41-35.5 — Health maintenance contracts required to cover low-dosemammography--Extent of coverage.
- 58-41-35.6 — Exclusion of benefits for injury while under the influence of alcohol ordrugs prohibited--Exception for sickness or injury caused in commissionof felony.
- 58-41-36 — Unfair and misleading information in evidence of coverage asmisdemeanor.
- 58-41-37 — Deceptive advertising or evidence of coverage as misdemeanor.
- 58-41-38 — Statements deemed untrue.
- 58-41-39 — Statements deemed misleading.
- 58-41-40 — Evidence of coverage deemed deceptive.
- 58-41-41 — Issuance to enrollees of change in evidence of coverage.
- 58-41-42 — Evidence of coverage to be approved before use--Violation asmisdemeanor.
- 58-41-43 — Filing and approval requirements applicable.
- 58-41-44 — Charges to enrollees--Fairness--Actuary's certificate.
- 58-41-45 — Discrimination as misdemeanor.
- 58-41-46 — Filing and approval of schedule of charges required--Exception foremployer sponsored plan.
- 58-41-47 — Approval of forms and schedules--Time.
- 58-41-48 — Notice of disapproval of filing--Request for hearing.
- 58-41-49 — Information required by director.
- 58-41-50 — Authorized expenses.
- 58-41-51 — Cancellation or nonrenewal of coverage--Grounds--Notice--Violation asmisdemeanor.
- 58-41-51.1 — Individual policy required for covered spouse of insured--Eligibility--Coverage--Waiting periods.
- 58-41-51.2 — Conversion privileges of insured's spouse upon divorce.
- 58-41-51.3 — Continuation and conversion coverage to be offered.
- 58-41-52 — Contracts with providers of health care services.
- 58-41-53 — Repealed.
- 58-41-54 — Contracts with insurance companies and nonprofit health service plancorporations authorized--Limitations.
- 58-41-55 — Insurance contracts authorized--Group coverage--Benefit payments.
- 58-41-56 — Contracts for management and administrative services authorized.
- 58-41-57 — Payment of unreasonably high expenses as misdemeanor.
- 58-41-58 — Repealed.
- 58-41-63 — General annual report required--Form and contents.
- 58-41-64 — Repealed.
- 58-41-65 — Applications, filings and reports as public documents.
- 58-41-66 — Annual summary for enrollees required--Contents.
- 58-41-67 — Rules--Minimum services and permissible exclusions.
- 58-41-68 — Periodic examination of activities.
- 58-41-69 — Examination of finances and provider agreements--Minimum frequency.
- 58-41-70 — Examination of health care services--Minimum frequency.
- 58-41-71 — Investigative powers of director and secretary.
- 58-41-72 — Administration of oaths--Subpoena power.
- 58-41-73 — Physician-patient privileges.
- 58-41-74 — Confidential data--Exceptions.
- 58-41-75 — Assessment of examination expense.
- 58-41-76 — Examination report from another state.
- 58-41-77 — Repealed.
- 58-41-78 — Cease and desist orders.
- 58-41-79 — Hearing on cease and desist order--Procedure--Judicial review.
- 58-41-80 — Injunctive relief against violations--Venue.
- 58-41-81 — Suspension or revocation of certificate of authority on findings bydirector.
- 58-41-82 — Suspension or revocation on grounds certified by secretary of health.
- 58-41-83 — Voluntary conference before commencing actions for violation.
- 58-41-84 — Informality in voluntary conferences.
- 58-41-85 — Money penalty in lieu of suspension or revocation.
- 58-41-86 — Requirements for suspension or revocation.
- 58-41-86.1 — Suspension without notice or hearing.
- 58-41-87 — Notice of grounds for denial, suspension, or revocation of certificate--Time of hearing--Summary proceedings excepted.
- 58-41-88 — Administrative procedure and rules.
- 58-41-89 — Participation of health department in hearings--Findings on health careconclusive.
- 58-41-90 — Action of directors after hearing--Written findings.
- 58-41-91 — Judicial review--Power of court.
- 58-41-92 — Activities prohibited during suspension of certificate.
- 58-41-93 — Winding up after revocation of certificate--Continued operation toprotect enrollees.
- 58-41-94 — Summary proceeding to reorganize organization--Grounds.
- 58-41-95 — Rehabilitation, liquidation, or conservation under insurance companylaws.
- 58-41-96 — Severability of provisions.
- 58-41-97 — Citation of chapter.
- 58-41-98 — Coverage for phenylketonuria.
- 58-41-99 — Formation of voluntary health insurance purchasing organizations.
- 58-41-100 — Membership of voluntary health insurance purchasing organizations.
- 58-41-101 — Purchasing organization's responsibility for negotiating terms andconditions.
- 58-41-102 — Purchasing organization's notice of premium charge.
- 58-41-103 — Additional chapters applicable to purchasing organization.
- 58-41-104 — Approval of purchasing organization by Division of Insurance.
- 58-41-105 — Premiums held in trust by purchasing organization.
- 58-41-106 — Rates for group health insurance issued to purchasing organizations.
- 58-41-107 — Reasonable participation requirements for group members of purchasingorganizations.
- 58-41-108 — Purchasing organizations exempt from antitrust provisions.
- 58-41-109 — Promulgation of rules for purchasing organizations.
- 58-41-110 — Application of chapter to provider contracting with state.
- 58-41-111 — Application of chapter to provider contracting with licensed healthmaintenance organization.
- 58-41-112 — Minimum inpatient care coverage following delivery.
- 58-41-113 — Shorter hospital stay permitted--Follow-up visit within forty-eight hoursrequired.
- 58-41-114 — Notice to enrollees--Disclosures.
- 58-41-115 — Health insurance policies to provide coverage for biologically-basedmental illnesses.
- 58-41-116 — Application--Exemptions.
- 58-41-117 — Policies to provide coverage for diabetes supplies, equipment, andeducation--Exceptions--Conditions and limitations.
- 58-41-118 — Diabetes coverage not required of certain plans and policies.
- 58-41-119 — Contracts to provide coverage for prostate cancer screening.