2013 Mississippi Code
Title 83 - INSURANCE
Chapter 41 - HOSPITAL AND MEDICAL SERVICE ASSOCIATIONS AND CONTRACTS
Article 7 - HEALTH MAINTENANCE ORGANIZATION, PREFERRED PROVIDER ORGANIZATION AND OTHER PREPAID HEALTH BENEFIT PLANS PROTECTION ACT
§ 83-41-349 - Imposition of administrative penalties; informal proceedings for investigation and correction or prevention of violations; cease and desist orders

(1) The commissioner may, in lieu of suspension or revocation of a certificate of authority under Section 83-41-339, levy an administrative penalty in an amount not less than One Hundred Dollars ($ 100.00) per violation, nor more than One Thousand Dollars ($ 1,000.00) per violation, if reasonable; notice in writing is given of the intent to levy the penalty and the health maintenance organization has a reasonable time within which to remedy the defect in its operations which gave rise to the penalty citation. The commissioner may augment this penalty by an amount equal to the sum that he calculates to be the damages suffered by enrollees or other members of the public.

(2) (a) If the commissioner or the State Health Officer shall for any reason have cause to believe that any violation of this article has occurred or is threatened, the commissioner or State Health Officer may give notice to the health maintenance organization and to the representatives, or other persons who appear to be involved in the suspected violation, to arrange a hearing with the alleged violators or their authorized representatives for the purpose of attempting to ascertain the facts relating to the suspected violation; and, if it appears that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing the violation.

(b) Proceedings under this subsection shall not be governed by any formal procedural requirements, and may be conducted in such manner as the commissioner or the State Health Officer may deem appropriate under the circumstances. However, unless consented to by the health maintenance organization, no rule or order may result from a conference until the requirements of this section of this article are satisfied.

(3) (a) The commissioner may issue an order directing a health maintenance organization or a representative of a health maintenance organization to cease and desist from engaging in any act or practice in violation of the provisions of this article.

(b) Within ten (10) days after service of the cease and desist order, the respondent may request a hearing on the question of whether acts or practices in violation of this article have occurred. The hearings shall be conducted pursuant to rules of practice and procedure before the Mississippi Insurance Department and judicial review shall be available as provided by Section 83-41-339.

(4) In the case of any violation of the provisions of this article, if the commissioner elects not to issue a cease and desist order, or in the event of noncompliance with a cease and desist order issued pursuant to subsection (3), the commissioner may institute a proceeding to obtain injunctive or other appropriate relief in the Chancery Court of the First Judicial District of Hinds County, Jackson, Mississippi.

(5) Notwithstanding any other provisions of this article, if a health maintenance organization fails to comply with the net worth requirement of this article, the commissioner is authorized to take appropriate action to assure that the continued operation of the health maintenance organization will not be hazardous to its enrollees.