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Chapter: 2J -

26:2J-1: Short title

26:2J-2: Definitions

26:2J-3: Establishment of health maintenance organizations

26:2J-4: Issuance of certificate of authority

26:2J-4.1: Health maintenance organization to pay benefits for treatment of Wilm's tumor

26:2J-4.2: Health maintenance organization to offer basic health services coverage

26:2J-4.3: Limitations on basic health care services

26:2J-4.4: Health maintenance organization, mammogram examination benefits.

26:2J-4.5: Health maintenance organization, benefits for "off-label" drugs required

26:2J-4.6: Health maintenance organization, benefits for health promotion.

26:2J-4.7: Requirements for health maintenance organization providing benefits for pharmacy services.

26:2J-4.8: Benefits for certain cancer treatments

26:2J-4.9: Coverage for birth and natal care; HMO

26:2J-4.10: Health maintenance organization, child screening, blood lead, hearing loss; immunizations.

26:2J-4.11: Coverage for diabetes treatment by HMO contracts

26:2J-4.12: HMO contracts, Pap smear benefits.

26:2J-4.13: HMO certificate of authority, prostate cancer testing

26:2J-4.14: HMO to provide benefits for reconstructive breast surgery.

26:2J-4.15: Coverage for minimum inpatient care following mastectomy by HMO.

26:2J-4.16: Applicability of Health Care Quality Act

26:2J-4.17: Coverage for treatment of inherited metabolic diseases by health maintenance organization.

26:2J-4.18: Coverage for treatment of domestic violence injuries by health maintenance organization.

26:2J-4.19: Coverage for certain dental procedures for the severely disabled or child age five or under by HMO.

26:2J-4.20: HMO to provide coverage for biologically based mental illness.

26:2J-4.21: HMO to provide continuing nursing home care, certain.

26:2J-4.22: Coverage for hemophilia services by HMO

26:2J-4.23: Health maintenance organization to provide coverage for treatment of infertility.

26:2J-4.24: HMO agreement to provide coverage for colorectal cancer screening.

26:2J-4.25: Health maintenance organization prescription drug plans to cover certain infant formulas.

26:2J-4.26: HMO required to cover certain out-of-network services.

26:2J-4.27: HMO to offer coverage for domestic partner.

26:2J-4.28: HMO, high deductible, coverage for preventive care.

26:2J-4.29: Health service corporation, coverage for prescription female contraceptives.

26:2J-4.30: Health maintenance organization, coverage for prescription female contraceptives.

26:2J-4.31: HMOs to provide benefits for orthotic and prosthetic appliances.

26:2J-4.32: Health maintenance organization to provide coverage for hearing aids for certain persons aged 15 or younger.

26:2J-4.33: Health maintenance organization to provide installment payments to obstetrical provider for maternity services.

26:2J-4.34: Health maintenance organization to provide benefits for treatment of autism or other developmental disability.

26:2J-4.35: HMO to provide coverage for oral anticancer medications.

26:2J-4.36: HMO to provide coverage for sickle cell anemia.

26:2J-4.37: Health maintenance organization to provide coverage for prescription eye drops.

26:2J-4.38: Health maintenance organization, coverage for synchronization of prescribed medications.

26:2J-4.39: Health maintenance organization contract to provide benefits for substance use disorder.

26:2J-4.40: Health maintenance organization to provide coverage regardless of gender identity, expression.

26:2J-4.41: HMO to cover digital tomosynthesis of the breast.

26:2J-4.42: HMO to provide coverage for donated human breast milk.

26:2J-4.43: Health maintenance organization to provide coverage for standard fertility preservation services.

26:2J-4.44: Health maintenance organization to provide coverage for breastfeeding support.

26:2J-4.45: Health maintenance organization to cover preventive services.

26:2J-4.46: Health maintenance organization to provide certain coverage for prescription drugs.

26:2J-4.47: Health maintenance organization to cover adolescent depression screenings.

26:2J-4.48: HMO to cover newborn home nurse visitation.

26:2J-5: Powers of health maintenance organizations

26:2J-6: Governing body

26:2J-7: Protection against wrongful acts

26:2J-8: Evidence of coverage

26:2J-8.1: Health maintenance organization to receive, transmit transactions electronically; standards.

26:2J-9: Annual report

26:2J-10: Information to enrollees

26:2J-10.1: Coverage provided by health maintenance organization for subscriber's child

26:2J-10.2: Requirements applicable to State Medicaid

26:2J-10.3: Coverage for certain dependents until age 31 by health maintenance organization.

26:2J-11: Annual open enrollment period

26:2J-11.1: Failure to agree on terms; four-month extension; notification of options

26:2J-12: Complaint system

26:2J-13: Investments

26:2J-14: Protection against insolvency

26:2J-15: Prohibited practices for health maintenance organization

26:2J-15.1: Health care services contract, exclusion, rates, terms based on genetic information prohibited

26:2J-16: Regulation of agents

26:2J-17: Powers of insurers and hospital and medical service corporations

26:2J-18: Examinations

26:2J-18.1: Examination of HMO by Commissioner of Banking and Insurance.

26:2J-18.2: Definitions relative to risk based capital requirements for HMOs.

26:2J-18.3: Increase of capital, surplus; methods, procedures.

26:2J-18.4: Factors in determining change in capital, surplus.

26:2J-18.5: Noncompliance, penalties.

26:2J-18.6: Regulations.

26:2J-19: Suspension or revocation of certificate of authority

26:2J-21: Regulation

26:2J-22: Administrative procedures

26:2J-23: Fees.

26:2J-24: Administrative penalty; enforcement

26:2J-25: Statutory construction and relationship to other laws.

26:2J-26: Filings and reports as public documents.

26:2J-27: Confidentiality of medical information

26:2J-28: Commissioner of health's authority to contract

26:2J-29: Enrollment of State employees

26:2J-30: Severability

26:2J-31: Definitions

26:2J-32: Applicability of act

26:2J-33: Avoidance of duplication of benefits, regulations

26:2J-34: Coverage for preexisting condition

26:2J-35: Regulations

26:2J-36: Authorization for health maintenance organization to offer, provide medicare supplement health care services

26:2J-37: Submission of underlying plan; rate filings

26:2J-38: Outline of coverage delivered to applicant

26:2J-39: 30-day return provision, refunds

26:2J-40: Filing of copy of advertising materials, regulations

26:2J-41: Additional remedies

26:2J-42: Health maintenance organization contract; compliance

26:2J-43: Filing of contract or related form

26:2J-44: Contract forms; certification memorandum

26:2J-47: Special interim assessment on HMOs, annual assessment beginning in FY2007; rates.

26:2J-48: Health maintenance organization, aggregate benefits.