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2023 South Dakota Codified Laws
Title 58 - Insurance
Chapter 41 - Health Maintenance Organizations
- Section 58-41-1 - Definition of terms.
- Section 58-41-2 - Organizations subject to chapter.
- Section 58-41-3 - Certificate of authority required for health maintenance organization or contracts--Violation as misdemeanor.
- Section 58-41-4 - Application for certificate of authority required.
- Section 58-41-5 - 58-41-5.Repealed by SL 1985, ch 393, §7
- Section 58-41-6 - Verification and form of application--Contents.
- Section 58-41-7 - Financial statements required with application.
- Section 58-41-8 - Copies of forms required with application.
- Section 58-41-9 - Marketing, charges, and financial plans required with application.
- Section 58-41-10 - Appointment to receive process required of foreign applicant.
- Section 58-41-11 - Surety bond or deposit required--Waiver.
- Section 58-41-12 - Determination of health care qualifications.
- Section 58-41-13 - Coordination with federal professional standards review.
- Section 58-41-14 - 58-41-14.Obsolete
- Section 58-41-15 - Health maintenance not considered practice of healing arts.
- Section 58-41-15.1 - Certain healing arts practitioners to participate in alternate health care delivery systems.
- Section 58-41-16 - 58-41-16.Repealed by SL 2013, ch 256, §7.
- Section 58-41-17 - Issuance or denial of certificate--Fee--Conditions for issuance.
- Section 58-41-18 - Factors considered in determining financial responsibility.
- Section 58-41-19 - Insurance arrangements permitted.
- Section 58-41-20 - Corporation operating after certification.
- Section 58-41-21 - Foreign corporations qualifying--Exemption from other requirements.
- Section 58-41-22 - Filing of notice of modification of operation--Approval if not disapproved--Exemptions.
- Section 58-41-23 - Composition of governing body--Consumer representation.
- Section 58-41-24 - Mechanisms for enrollee participation in policy and operation of governing body.
- Section 58-41-25 - Fiduciary responsibilities to enrollees.
- Section 58-41-25.1 - Investments.
- Section 58-41-26 - Exemption from insurance laws--Exceptions--Taxation.
- Section 58-41-27 - 58-41-27.Repealed by SL 1985, ch 393, §9
- Section 58-41-28 - Solicitation of enrollment not deemed professional advertising.
- Section 58-41-29 - Contracts and necessary activities.
- Section 58-41-29.1 - Notice required for rate increase in health maintenance contract by a health maintenance organization.
- Section 58-41-30 - Sources of payment for enrollee services--Application by medical assistance recipient.
- Section 58-41-31 - Direct payments to enrollees prohibited.
- Section 58-41-32 - Use of words descriptive of insurance, casualty, or surety business as misdemeanor--Exception.
- Section 58-41-33 - Trade practice laws applicable.
- Section 58-41-34 - Evidence of coverage issued to enrollees.
- Section 58-41-35 - Contents required in evidence of coverage.
- Section 58-41-35.1 - Alcoholism coverage to be offered at time contract is negotiated.
- Section 58-41-35.2 - 58-41-35.2 to 58-41-35.4.Repealed by SL 2001, ch 274, §§10 to 12
- Section 58-41-35.5 - Grandfathered contracts required to cover low-dose mammography--Extent of coverage.
- Section 58-41-35.6 - Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony.
- Section 58-41-35.7 - Contracts required to cover occult breast cancer screening.
- Section 58-41-36 - Unfair and misleading information in evidence of coverage as misdemeanor.
- Section 58-41-37 - Deceptive advertising or evidence of coverage as misdemeanor.
- Section 58-41-38 - Statements deemed untrue.
- Section 58-41-39 - Statements deemed misleading.
- Section 58-41-40 - Evidence of coverage deemed deceptive.
- Section 58-41-41 - Issuance to enrollees of change in evidence of coverage.
- Section 58-41-42 - Evidence of coverage to be approved before use--Violation as misdemeanor.
- Section 58-41-43 - Filing and approval requirements applicable.
- Section 58-41-44 - Charges to enrollees--Fairness--Actuary's certificate.
- Section 58-41-45 - Discrimination as misdemeanor.
- Section 58-41-46 - 58-41-46 to 58-41-49.Repealed by SL 2013, ch 256, §§12 to 15.
- Section 58-41-50 - Authorized expenses.
- Section 58-41-51 - 58-41-51.Repealed by SL 2013, ch 256, §16.
- Section 58-41-51.1 - Individual policy required for covered spouse of insured--Eligibility--Coverage--Waiting periods.
- Section 58-41-51.2 - Conversion privileges of insured's spouse upon divorce.
- Section 58-41-51.3 - Continuation and conversion coverage to be offered.
- Section 58-41-52 - Contracts with providers of health care services.
- Section 58-41-52.1 - Collection for covered services prohibited.
- Section 58-41-52.2 - Contracts--Hold harmless provision.
- Section 58-41-52.3 - Hold harmless provision--Language of provision.
- Section 58-41-53 - 58-41-53.Repealed by SL 1999, ch 245, §21
- Section 58-41-54 - Contracts with insurance companies and nonprofit health service plan corporations authorized--Limitations.
- Section 58-41-55 - Insurance contracts authorized--Group coverage--Benefit payments.
- Section 58-41-56 - Contracts for management and administrative services authorized.
- Section 58-41-57 - Payment of unreasonably high expenses as misdemeanor.
- Section 58-41-58 - 58-41-58 to 58-41-62.Repealed by SL 1996, ch 296, §§9 to 13
- Section 58-41-63 - General annual report required--Form and contents.
- Section 58-41-64 - 58-41-64.Repealed by SL 1985, ch 393, §10
- Section 58-41-65 - Applications, filings and reports as public documents.
- Section 58-41-66 - Annual summary for enrollees required--Contents.
- Section 58-41-67 - Promulgation of rules.
- Section 58-41-68 - 58-41-68 to 58-41-72.Repealed by SL 2013, ch 256, §§20 to 24.
- Section 58-41-73 - Physician-patient privileges.
- Section 58-41-74 - Confidential data--Exceptions.
- Section 58-41-75 - 58-41-75, 58-41-76.Repealed by SL 2013, ch 256, §§25, 26.
- Section 58-41-77 - 58-41-77.Repealed by SL 1978, ch 359, §3
- Section 58-41-78 - Cease and desist orders.
- Section 58-41-79 - Hearing on cease and desist order--Procedure--Judicial review.
- Section 58-41-80 - Injunctive relief against violations--Venue.
- Section 58-41-81 - Suspension or revocation of certificate of authority on findings by director.
- Section 58-41-82 - Additional grounds for suspension or revocation.
- Section 58-41-83 - Voluntary conference before commencing actions for violation.
- Section 58-41-84 - Informality in voluntary conferences.
- Section 58-41-85 - Money penalty in lieu of suspension or revocation.
- Section 58-41-86 - Requirements for suspension or revocation.
- Section 58-41-86.1 - Suspension without notice or hearing.
- Section 58-41-87 - Notice of grounds for denial, suspension, or revocation of certificate--Time of hearing--Summary proceedings excepted.
- Section 58-41-88 - Administrative procedure and rules.
- Section 58-41-89 - 58-41-89.Repealed by SL 2013, ch 256, §32.
- Section 58-41-90 - Action of director after hearing--Written findings.
- Section 58-41-91 - Judicial review.
- Section 58-41-92 - Activities prohibited during suspension of certificate.
- Section 58-41-93 - Winding up after revocation of certificate--Continued operation to protect enrollees.
- Section 58-41-94 - Summary proceeding to reorganize organization--Grounds.
- Section 58-41-95 - Rehabilitation, liquidation, or conservation under insurance company laws.
- Section 58-41-96 - Severability of provisions.
- Section 58-41-97 - Citation of chapter.
- Section 58-41-98 - Coverage for phenylketonuria.
- Section 58-41-99 - Formation of voluntary health insurance purchasing organizations.
- Section 58-41-100 - Membership of voluntary health insurance purchasing organizations.
- Section 58-41-101 - Purchasing organization's responsibility for negotiating terms and conditions.
- Section 58-41-102 - Purchasing organization's notice of premium charge.
- Section 58-41-103 - Additional chapters applicable to purchasing organization.
- Section 58-41-104 - Approval of purchasing organization by Division of Insurance.
- Section 58-41-105 - Premiums held in trust by purchasing organization.
- Section 58-41-106 - Rates for group health insurance issued to purchasing organizations.
- Section 58-41-107 - Reasonable participation requirements for group members of purchasing organizations.
- Section 58-41-108 - Purchasing organizations exempt from antitrust provisions.
- Section 58-41-109 - Promulgation of rules for purchasing organizations.
- Section 58-41-110 - Application of chapter to provider contracting with state.
- Section 58-41-111 - Application of chapter to provider contracting with licensed health maintenance organization.
- Section 58-41-112 - Minimum inpatient care coverage following delivery.
- Section 58-41-113 - Shorter hospital stay permitted--Follow-up visit within forty-eight hours required.
- Section 58-41-114 - Notice to enrollees--Disclosures.
- Section 58-41-115 - Health insurance policies to provide coverage for biologically-based mental illnesses.
- Section 58-41-116 - Application--Exemptions.
- Section 58-41-117 - Policies to provide coverage for diabetes supplies, equipment, and education--Exceptions--Conditions and limitations.
- Section 58-41-118 - Diabetes coverage not required of certain plans and policies.
- Section 58-41-119 - Contracts to provide coverage for prostate cancer screening.
- Section 58-41-120 - Annual report on risk bearing entities.
- Section 58-41-121 - Documents provided to risk bearing entity by health maintenance organization.
- Section 58-41-122 - Documents provided to health maintenance organization by risk bearing entity.
- Section 58-41-123 - Notice by risk bearing entity of change in conditions--Assignment of contract.
- Section 58-41-124 - Notice to director that risk bearing entity has materially failed to perform contract.
- Section 58-41-125 - Confidentiality of information.
- Section 58-41-126 - Nontransferable responsibilities of health maintenance organization.
- Section 58-41-127 - Coverage for treatment of hearing impairment for persons under age nineteen.
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