Title 83, Insurance

(1) An insurance company licensed in this state, or a hospital or medical service corporation authorized to do business in this state, may either directly or through a subsidiary or affiliate organize and operate a health maintenance organization under the provisions of this arti…

(1) The commissioner shall make an examination of the affairs of any health maintenance organization and providers with whom such organization has contracts, agreements or other arrangements as often as is reasonably necessary for the protection of the interests of the people of …

(1) Any certificate of authority issued under this article may be suspended or revoked, and any application for a certificate of authority may be denied, if the commissioner after a hearing finds that any of the conditions listed below exist:(a) The health maintenance organizatio…

(1) Any rehabilitation, liquidation or administrative supervision of a health maintenance organization shall be deemed to be the same as the rehabilitation, liquidation or administrative supervision of an insurance company and shall be conducted under the supervision of the commi…

(1) Whenever the commissioner determines that the financial condition of any health maintenance organization is such that its continued operation might be hazardous to its enrollees, creditors, or the general public, or that it has violated any provision of this article, he may, …

The commissioner may, after notice and hearing, promulgate reasonable rules and regulations, as are necessary or proper to carry out the provisions of this article.

(1) Every health maintenance organization subject to this article shall pay to the commissioner the following fees:(a) For filing an application for a certificate of authority for a health maintenance organization and amendment thereto$5,000.00;(b) For filing an amendment to the …

(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…

(1) This provision shall not apply to an insurer or hospital or medical service corporation licensed and regulated pursuant to the insurance law or the hospital or medical service corporation laws of this state except with respect to its health maintenance organization activities…

All applications, filings and reports required under this article shall be treated as public documents, except those which are trade secrets or privileged or confidential quality assurance, commercial or financial information, other than any annual financial statement that may be…

(1) Any data or information pertaining to the diagnosis, treatment or health of any enrollee or applicant obtained from the person or from any provider by any health maintenance organization shall be held in confidence and shall not be disclosed to any person except to the extent…

The State Health Officer in carrying out his obligations under this article, may contract with qualified persons to make recommendations concerning the determinations required to be made by him. The recommendations may be accepted in full or in part by the State Health Officer.

No person may make a tender for or a request or invitation for tenders of, or enter into an agreement to exchange securities for or acquire in the open market or otherwise, any voting security of a health maintenance organization or enter into any other agreement if, after the co…

(1) Health maintenance organizations are permitted, but not required, to adopt coordination of benefits provisions to avoid overinsurance and to provide for the orderly payment of claims when a person is covered by two (2) or more group health insurance or health care plans. (2) …

(1) When a health maintenance organization in this state is declared insolvent by a court of competent jurisdiction, the commissioner may levy an assessment on health maintenance organizations doing business in this state to pay claims for uncovered expenditures for enrollees who…

The commissioner may contract with the necessary personnel to carry out the duties and responsibilities created by this article and make assessments for the expenses incurred in carrying out the duties and responsibilities of this article.

This article shall be known and may be cited as the “Patient Protection Act of 1995.”

(a) As used in this article:(a) “Department” means the Mississippi Department of Insurance.(b) “Managed care plan” means a plan operated by a managed care entity as described in paragraph (c) of this section that provides for the financing and delivery of health care services to …

The department shall establish a process for the certification of managed care plans offered or provided to persons residing in Mississippi. No such plan shall be offered or provided to persons residing in this state unless it has been certified by the department. Any managed car…

The department shall establish a fee to cover the costs of issuing and renewing the certifications authorized by this article and the fees shall be used solely for the administration of this article.

(a) In order to be certified and recertified under this article, a managed care plan shall:(a) Provide enrollees or other applicants with written information on the terms and conditions of coverage in easily understandable language including, but not limited to, information on th…

Health maintenance organizations must comply with the certification requirements in this article in addition to such other laws as might relate thereto.

The department shall adopt regulations to implement the provisions of this article and may obtain any information from managed care plans that is necessary to determine if such plan should be certified or recertified.

Articles 7 and 9 do not apply to the Division of Medicaid in the Office of the Governor.

A health maintenance organization as defined in Section 83-41-303, and a managed care entity as defined in Section 83-41-403, shall establish procedures to give interested health care providers located in the geographic area served an opportunity to apply for participation.

This chapter shall be known and may be cited as the “Nonprofit Dental Service Corporation Law.”

(1) A nonprofit dental service corporation may, by its articles of incorporation, its bylaws, or resolutions of its board of directors, limit the dental services that it will provide for its subscribers and may divide such dental services as it elects to provide into classes or k…

(1) Every dentist practicing within the area covered by any nonprofit dental service corporation shall have the right, on complying with such regulations as the corporation may make and with the approval of the state board of health, to register with such corporation for general …

(a) In addition to the rights and powers that may be exercised by nonprofit corporations under Sections 79-11-1 through 79-11-33, Mississippi Code of 1972, nonprofit dental service corporations created and organized under the provisions of this chapter shall be authorized to exer…

(a) A nonprofit dental service corporation may, as a condition precedent to entering into a contract with an applicant or group of applicants for dental service:(a) Require a physical examination of the applicant and of each of his dependents, if any, and proof of his or their su…

Every department, commission, officer, or other agency of the state, or of any political subdivision thereof, who is authorized or charged by law with the duty of providing dental services within the meaning of this chapter for persons unable to provide it entirely at their own e…

Every nonprofit dental service corporation shall, on or before the first day of March of every year, file with the state auditor of public accounts a statement verified by at least two (2) of the principal officers of the corporation, summarizing its financial activities during t…

Surplus funds, if any, of any such corporation may be invested and, if invested, shall be in compliance with the requirements of law for the investment of the surplus of life insurance companies.

Every nonprofit dental service corporation shall, on or before the first day of March of every year, file with the state board of health a report of its activities other than its financial activities during the calendar year immediately preceding. Every such report shall be authe…

Any nonprofit dental service corporation may select any person, copartnership, association, common law trust, or corporation to act as its agent in the performance of any of its functions. Any such delegation of authority shall not operate to release the nonprofit dental service …

Any dentist and any other person, copartnership, association, common law trust, or corporation who violates any provision of this chapter or of any order of the state board of health, of the attorney general, or of the state auditor made pursuant thereto, or that either prevents …

(a) As used in this chapter:(a) “Dentists” means persons holding a license to practice dentistry under Sections 73-9-1 through 73-9-65, Mississippi Code of 1972.(b) “Dental services” include the general and usual services rendered and care administered by dentists as defined in S…

When necessary to effect the purposes of this chapter, in addition to all other remedies in law or equity, the attorney general or state auditor, the secretary of the state board of health, or either of them, may be and are hereby authorized to petition the court for a mandamus o…

Every corporation organized pursuant to, or subject to, the provisions of this chapter is hereby declared to be a charitable and benevolent institution, and its funds and property shall be exempt from taxation, except, however, that such corporation shall not be exempt from ad va…

Any dissolution or liquidation of a corporation subject to the provisions of this chapter shall be conducted under the supervision of the attorney general and the state board of health. All assets of the corporation shall, upon dissolution or liquidation and after adequate provis…

It is hereby declared to be the purpose and intent of this chapter and the policy of the legislature to authorize qualified dentists engaged in private practice to provide adequate dental services for residents of this state through a sound prepayment plan with the cooperation of…

It shall be unlawful for any person, copartnership, association, common law trust, or corporation, except when especially organized and authorized under the provisions of the nonprofit corporation statutes for the purpose, to establish, maintain, or operate a nonprofit dental ser…

A nonprofit dental service corporation shall be subject to regulation and supervision by the state board of health, state auditor, and the attorney general as provided by this chapter. It shall not be subject to the laws of this state now in force, except as herein specifically s…

A nonprofit dental service corporation may not enter into dental service contracts under the provisions hereof until it has procured a formal certificate or license from the state board of health authorizing it to do so. Application for such certificate of authority or license sh…

The operation of a blood supply plan, on a nonprofit, community service basis, for the purpose of promoting and encouraging the donation of human blood for medicinal and transfusion uses may or may not constitute the writing of insurance. However, an agreement between such a nonp…

General administrative expenses shall be submitted to and approved by the department of insurance.