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0 chapters · 1,747 sections in this title.
La. Rev. Stat. § 22:2468 Alternative method of delivery required
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§2468. Alternative method of delivery required An insurer shall deliver a notice or document by any other delivery method permitted by law other than electronic means if either of the following occurs: (1) The insurer attempts to deliver the notice or document by electronic means…
La. Rev. Stat. § 22:2469 Limitation of liability
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§2469. Limitation of liability An insurance producer shall not be subject to civil liability for any harm or injury that occurs because of a party's election to receive any notice or document by electronic means or by an insurer's failure to deliver or a party's failure to receiv…
La. Rev. Stat. § 22:247 Reimbursement for chiropractic services
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§247. Reimbursement for chiropractic services Notwithstanding any provision of any policy or contract of insurance or health benefits issued by a health maintenance organization, whenever such policy or contract provides for payment or reimbursement for any service, and such serv…
La. Rev. Stat. § 22:2471 Authority of the commissioner
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§2471. Authority of the commissioner The commissioner may apply on behalf of the state of Louisiana for a state innovation waiver pursuant to Section 1332 of Public Law 111-148, 42 U.S.C. 18052, and establish and implement a reinsurance program administered pursuant to the state …
La. Rev. Stat. § 22:248 Issuance of certificate of authority
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§248. Issuance of certificate of authority A. Within ninety days of receipt of a completed application, the commissioner shall issue a certificate of authority to do business in the state to a corporation filing an application and paying the prescribed fees, if the commissioner d…
La. Rev. Stat. § 22:249 Authority of health maintenance organizations
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§249. Authority of health maintenance organizations Subject to the provisions of R.S. 22:260(E) and regulations adopted and approved by the commissioner, the authority of a health maintenance organization includes but is not limited to the following: (1) The authority to purchase…
La. Rev. Stat. § 22:250 Fiduciary duties of certain persons; bond required; encumbering assets
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§250. Fiduciary duties of certain persons; bond required; encumbering assets A. Any director, officer, or employee of a health maintenance organization who receives, collects, disburses, or invests funds in connection with the activities of such health maintenance organization sh…
La. Rev. Stat. § 22:2501 Short title
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§2501. Short title This Chapter shall be known and may be cited as the "Insurance Data Security Law". Acts 2020, No. 283, §1.
La. Rev. Stat. § 22:2502 Purpose and intent
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§2502. Purpose and intent A. This Chapter establishes the exclusive standards for this state applicable to licensees for data security, the investigation of a cybersecurity event, and notification to the commissioner. B. This Chapter shall not be construed to create or imply a pr…
La. Rev. Stat. § 22:2503 Definitions
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§2503. Definitions As used in this Chapter, the following definitions apply: (1) "Authorized individual" means a natural person known to and screened by a licensee and determined to be necessary and appropriate to have access to the nonpublic information held by a licensee and it…
La. Rev. Stat. § 22:2504 Information security program
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§2504. Information security program A. A licensee shall develop, implement, and maintain a comprehensive, written information security program which satisfies all of the following criteria: (1) Is based on the licensee's risk assessment. (2) Contains administrative, technical, an…
La. Rev. Stat. § 22:2505 Investigation of a cybersecurity event
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§2505. Investigation of a cybersecurity event A. If a licensee learns that a cybersecurity event has or may have occurred, the licensee, or an outside vendor or service provider designated to act on behalf of the licensee, shall conduct a prompt investigation. B. During the inves…
La. Rev. Stat. § 22:2506 Notification of a cybersecurity event
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§2506. Notification of a cybersecurity event A. A licensee shall notify the commissioner without unreasonable delay but in no event later than three business days from a determination that a cybersecurity event involving nonpublic information that is in the possession of the lice…
La. Rev. Stat. § 22:2507 Powers of the commissioner
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§2507. Powers of the commissioner A. The commissioner may examine and investigate into the affairs of any licensee to determine whether the licensee has been or is engaged in any conduct in violation of this Chapter. This power is in addition to the powers which the commissioner …
La. Rev. Stat. § 22:2508 Confidentiality
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§2508. Confidentiality A. Any documents, materials, or other information in the control or possession of the commissioner that are furnished by a licensee or an employee or agent acting on behalf of a licensee pursuant to R.S. 22:2504 or 2506 or that are obtained by the commissio…
La. Rev. Stat. § 22:2509 Exemptions
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§2509. Exemptions A. A licensee shall be exempt from the provisions of R.S. 22:2504 if the licensee meets any of the following criteria: (1) Having fewer than twenty-five employees. (2) Less than five million dollars in gross annual revenue. (3) Less than ten million dollars in y…
La. Rev. Stat. § 22:251 Books and records of health maintenance organizations
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§251. Books and records of health maintenance organizations A. Every health maintenance organization shall maintain the books and records relating to activities conducted in the state in its offices within the state pursuant to the provisions of this Subpart. Such health maintena…
La. Rev. Stat. § 22:2510 Penalties
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§2510. Penalties In the case of a violation of this Chapter, the commissioner may impose a penalty pursuant to R.S. 22:18. Acts 2020, No. 283, §1.
La. Rev. Stat. § 22:2511 Defenses
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§2511. Defenses A licensee that satisfies the provisions of this Chapter may assert an affirmative defense to any cause of action arising in tort that is brought pursuant to the laws of this state or in the courts of this state and that alleges that the failure to implement reaso…
La. Rev. Stat. § 22:252 Annual report
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§252. Annual report A. On or before the first day of March, every health maintenance organization shall annually file a report with the commissioner covering the preceding calendar year and shall file a copy of the report with the secretary of the Louisiana Department of Health. …
La. Rev. Stat. § 22:253 Investments
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§253. Investments With the exception of investments made in accordance with R.S. 22:249(1) and (2) a health maintenance organization shall be restricted to making the same types of investments as permitted for the investment of assets by life insurance companies licensed to do bu…
La. Rev. Stat. § 22:254 Protection against insolvency
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§254. Protection against insolvency A. Repealed by Acts 2021, No. 159, §2, eff. July 1, 2021. B. Repealed by Acts 2021, No. 159, §2, eff. July 1, 2021. C. Each health maintenance organization shall establish prior to the issuance of any certificate of authority, and shall maintai…
La. Rev. Stat. § 22:255 Regulation of producers
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§255. Regulation of producers The commissioner may, in accordance with the Administrative Procedure Act, promulgate such reasonable rules and regulations as are necessary to provide for the licensing of producers. A "producer" means a person licensed as a life and health insuranc…
La. Rev. Stat. § 22:256 Examination of health maintenance organization and other parties
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§256. Examination of health maintenance organization and other parties A. The commissioner or a member of his staff may make an examination of the affairs of any health maintenance organization as often as it is reasonably necessary for the protection of the interest of the peopl…
La. Rev. Stat. § 22:257 Suspension or revocation of certificate of authority
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§257. Suspension or revocation of certificate of authority A. The commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization under this Subpart if he finds that any of the following conditions exist: (1) The health maintenance orga…
La. Rev. Stat. § 22:258 Regulations
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§258. Regulations The commissioner may promulgate such rules and regulations as may be necessary or proper to carry out the provisions of this Subpart. Such rules and regulations shall be subject to rulemaking and review in accordance with the Administrative Procedure Act. Acts 1…
La. Rev. Stat. § 22:259 Administrative procedures
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§259. Administrative procedures When the commissioner has cause to believe that grounds for the denial, suspension, or revocation of an application for a certificate of authority exist, in accordance with R.S. 49:977.3, the commissioner shall issue an order denying, suspending, o…
La. Rev. Stat. § 22:260 Statutory construction; relationship to other laws
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§260. Statutory construction; relationship to other laws A. Except as otherwise provided in this Subpart and in R.S. 22:1037, provisions of the insurance law and provisions of Subpart C of this Part, R.S. 22:111 et seq., shall not be applicable to any health maintenance organizat…
La. Rev. Stat. § 22:262 Technical advice, advisors, and other technical services
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§262. Technical advice, advisors, and other technical services A. The commissioner or the secretary may at any time call upon any other state agency, to serve as an advisor on technical or health care matters and for such technical data, statistics, or other information as he may…
La. Rev. Stat. § 22:263 Requirements of provider contracts; prohibited incentives; definitions
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§263. Requirements of provider contracts; prohibited incentives; definitions A. Every contract between a health maintenance organization and a provider of health care services shall be in writing, and shall set forth: (1) That in the event the health maintenance organization fail…
La. Rev. Stat. § 22:264 Restriction on alienations or transfers of certificate of authority
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§264. Restriction on alienations or transfers of certificate of authority A certificate of authority shall not be disposed of, sold, transferred, or utilized by any person other than the applicant except as authorized by the commissioner. An aggrieved party affected by the commis…
La. Rev. Stat. § 22:264.1 Prior approval required for merger of domestic health maintenance organization
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§264.1. Prior approval required for merger of domestic health maintenance organization No domestic health maintenance organization shall merge with another person without the prior approval of the commissioner, who may grant such approval upon written request of a domestic health…
La. Rev. Stat. § 22:265 Confidentiality of medical information
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§265. Confidentiality of medical information A. Any data or information pertaining to the diagnosis, treatment, or health of any enrollee or potential enrollee obtained from such persons or from any provider by any health maintenance organization shall be held in confidence and s…
La. Rev. Stat. § 22:2651 Short title
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§2651. Short title This Chapter shall be known as the "Hurricane Mediation Program", hereinafter referred to as the "program". Acts 2022, No. 591, §1, eff. Jan. 1, 2023.
La. Rev. Stat. § 22:2652 Purposes; public purpose
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§2652. Purposes; public purpose A. The purpose of this Chapter is to provide a nonadversarial alternative dispute resolution procedure that is prompted by the need for effective, fair, and timely handling of residential property insurance claims for residential properties that ar…
La. Rev. Stat. § 22:2653 Conditions to request mediation
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§2653. Conditions to request mediation A. Every insured may request mediation involving a residential property insurance claim for property damage that involves disputed amounts up to one hundred fifty thousand dollars in situations that the governor declares a state of emergency…
La. Rev. Stat. § 22:2654 Firm and department mediation requirements
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§2654. Firm and department mediation requirements A. A mediation firm, hereinafter referred to as the "firm", that elects to participate in the program provided in this Chapter shall comply with all of the following: (1) The firm contacts the department regarding participation in…
La. Rev. Stat. § 22:2655 Insurer and insured requirements for mediation
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§2655. Insurer and insured requirements for mediation The insurer and insured that elects to participate in mediation under the provisions of this Chapter shall agree to the following conditions: (1) The insurer shall bear the reasonable costs necessary to conducting mediation co…
La. Rev. Stat. § 22:2656 Alternative dispute resolution disclosure notice
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§2656. Alternative dispute resolution disclosure notice A. If the governor declares a state of emergency pursuant to R.S. 29:724 for a named windstorm event, an insurer writing residential property insurance in this state shall send a hurricane mediation program disclosure form t…
La. Rev. Stat. § 22:2657 Rules and regulations
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§2657. Rules and regulations The commissioner shall promulgate rules and regulations necessary to implement this Chapter. Acts 2022, No. 591, §1, eff. Jan. 1, 2023.
La. Rev. Stat. § 22:266 Medical necessity review
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§266. Medical necessity review Every health maintenance organization shall assure full compliance with Subpart F of Part III of Chapter 4 of this Title, R.S. 22:1121 et seq., in establishing procedures for continuous review of quality of care, performance of providers, utilizatio…
La. Rev. Stat. § 22:267 Enrollee grievance procedure
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§267. Enrollee grievance procedure A. Every health maintenance organization shall establish and maintain a grievance system approved by the commissioner under which enrollees may submit their grievances to the health maintenance organization. Each system shall provide reasonable …
La. Rev. Stat. § 22:268 Reports to the governor
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§268. Reports to the governor The secretary and the commissioner each shall report annually to the governor on the activities of his office with respect to health maintenance organizations and shall make such suggestions for change or improvement as may be in the best interest of…
La. Rev. Stat. § 22:269 Fees
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§269. Fees A. The following fees shall be collected in advance by the secretary of state for health maintenance organization: (1) For filing a charter, other documents, and amendments thereto, per page $ 2.50 (2) For certified copies of any document, per page $ 2.00 B. The follow…
La. Rev. Stat. § 22:271 Enrollment application; required statement; annual notification and disclosure of information
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§271. Enrollment application; required statement; annual notification and disclosure of information A. Every application for enrollment in a health maintenance organization shall contain the following statement conspicuously displayed on the front of such application in at least …
La. Rev. Stat. § 22:272 Notice required for certain prepaid charge rate increases, cancellation or nonrenewal
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§272. Notice required for certain prepaid charge rate increases, cancellation or nonrenewal of service agreements; other requirements A.(1) Every health maintenance organization regulated by this Subpart shall notify each master contract group in writing at least forty-five days …
La. Rev. Stat. § 22:281 Fraternal benefit societies
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§281. Fraternal benefit societies A fraternal benefit society is any incorporated society, order, or supreme lodge, without capital stock, including one exempted under the provisions of R.S. 22:317(A)(2), whether incorporated or not, conducted solely for the benefit of its member…
La. Rev. Stat. § 22:282 Lodge system defined
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§282. Lodge system defined A. A society is operating on the lodge system if it has a supreme governing body and subordinate lodges into which members are elected, initiated, or admitted in accordance with its laws, rules, and ritual. Subordinate lodges shall be required by the la…
La. Rev. Stat. § 22:283 Representative form of government defined
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§283. Representative form of government defined A. A society has a representative form of government when all of the following requirements are met: (1) It has a supreme governing body constituted in one of the following ways: (a) Assembly. The supreme governing body is an assemb…
La. Rev. Stat. § 22:284 General definitions
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§284. General definitions As used in this Subpart, the following terms shall have the meanings herein given to each unless the context clearly indicates otherwise: (1) "Benefit contract" means the agreement for provision of benefits authorized by R.S. 22:296, as that agreement is…
