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304.38A-090 Suspension or revocation of certificate of
Notification -- Winding up affairs -- Applicable provisions.
(1)
(2)
(3)
(4)
authority
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The commissioner may suspend or revoke the certificate of authority issued to
a limited health service organization pursuant to this subtitle upon determining
that any of the following conditions exist:
(a) The limited health service organization is operating significantly in
contravention of its basic organizational document or in a manner
contrary to that described in and reasonably inferred from any other
information submitted pursuant to KRS 304.38A-030, unless amendments
to the submissions have been filed with and approved by the
commissioner;
(b) The limited health service organization issues an evidence of coverage or
schedule of charges for limited health services which does not comply
with the requirements of Subtitle 17C of this chapter;
(c) The limited health service organization is unable to fulfill its obligations to
furnish limited health services;
(d) The limited health service organization is not financially responsible and
may reasonably be expected to be unable to meet its obligations to
enrollees or prospective enrollees;
(e) The net worth of the limited health service organization is less than that
required by KRS 304.38A-080 or the limited health service organization
has failed to correct any deficiency in its net worth as required by the
commissioner;
(f) The continued operation of the limited health service organization would
be hazardous to its enrollees; or
(g) The limited health service organization has otherwise failed to comply
with this subtitle.
If the commissioner has cause to believe that grounds for the suspension or
revocation of a certificate of authority exist, he or she shall notify the limited
health service organization in writing specifically stating the grounds for
suspension or revocation and fixing a time not more than sixty (60) days
thereafter for a hearing on the matter in accordance with KRS Chapter 13B.
When the certificate of authority of a limited health service organization is
revoked, the organization shall proceed immediately following the effective
date of the order of revocation to wind up its affairs, and shall conduct no
further business except as may be essential to the orderly conclusion of the
affairs of the organization. It shall engage in no further advertising or
solicitation whatsoever. The commissioner may, by written order, permit such
further operation of the organization as he or she may find to be in the best
interest of enrollees, to the end that enrollees will be afforded the greatest
practical opportunity to obtain continuing limited health services.
A limited health service organization shall be subject to the provisions of KRS
304.2-210 to 304.2-300 and to the provisions of Subtitle 2 of this chapter for
determining financial condition, market conduct, and business practices.
Effective:July 15, 2010
History: Amended 2010 Ky. Acts ch. 24, sec. 1522, effective July 15, 2010. --
Created 2002 Ky. Acts ch. 105, sec. 18, effective July 15, 2002.
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