(a) The Commissionermay suspend or revoke an HMO license if the Commissioner finds that the HMO:
(1) Is operatingsignificantly in contravention of its basic organizational document, or in amanner contrary to that described in and reasonably inferred from any otherinformation submitted under G.S. 58‑67‑10, unless amendments tosuch submissions have been filed with and approved by the Commissioner.
(2) Issues evidences ofcoverage or uses a schedule of premiums for health care services that do notcomply with G.S. 58‑67‑50.
(3) Is no longerfinancially responsible and may reasonably be expected to be unable to meet itsobligations to enrollees or prospective enrollees.
(4) Has itself orthrough any person on its behalf advertised or merchandised its services in anuntrue, misrepresentative, misleading, deceptive or unfair manner.
(5) Is operating in amanner that would be hazardous to its enrollees.
(6) Knowingly orrepeatedly fails or refuses to comply with any law or rule applicable to theHMO or with any order issued by the Commissioner after notice and opportunityfor a hearing.
(7) Has knowinglypublished or made to the Department or to the public any false statement orreport, including any report or any data that serves as the basis for anyreport, required to be submitted under G.S. 58‑3‑191.
(b) A license shall besuspended or revoked only after compliance with G.S. 58‑67‑155.
(c) When an HMO licenseis suspended, the HMO shall not, during the suspension, enroll any additionalenrollees except newborn children or other newly acquired dependents ofexisting enrollees, and shall not engage in any advertising or solicitation.
(d) When an HMO licenseis revoked, the HMO shall proceed, immediately following the effective date ofthe order of revocation, to wind up its affairs, and shall conduct no furtherbusiness except as may be essential to the orderly conclusion of the affairs ofthe HMO. The HMO shall engage in no advertising or solicitation. The Commissionermay, by written order, permit such further operation of the HMO as theCommissioner may find to be in the best interest of enrollees, to the end thatenrollees will be afforded the greatest practical opportunity to obtaincontinuing health care coverage. (1977, c. 580, s. 1; 1979, c. 876, s. 1; 1997‑519,s. 1.5; 2003‑212, ss. 22, 23, 26(l).)
(a) The Commissionermay suspend or revoke an HMO license if the Commissioner finds that the HMO:
(1) Is operatingsignificantly in contravention of its basic organizational document, or in amanner contrary to that described in and reasonably inferred from any otherinformation submitted under G.S. 58‑67‑10, unless amendments tosuch submissions have been filed with and approved by the Commissioner.
(2) Issues evidences ofcoverage or uses a schedule of premiums for health care services that do notcomply with G.S. 58‑67‑50.
(3) Is no longerfinancially responsible and may reasonably be expected to be unable to meet itsobligations to enrollees or prospective enrollees.
(4) Has itself orthrough any person on its behalf advertised or merchandised its services in anuntrue, misrepresentative, misleading, deceptive or unfair manner.
(5) Is operating in amanner that would be hazardous to its enrollees.
(6) Knowingly orrepeatedly fails or refuses to comply with any law or rule applicable to theHMO or with any order issued by the Commissioner after notice and opportunityfor a hearing.
(7) Has knowinglypublished or made to the Department or to the public any false statement orreport, including any report or any data that serves as the basis for anyreport, required to be submitted under G.S. 58‑3‑191.
(b) A license shall besuspended or revoked only after compliance with G.S. 58‑67‑155.
(c) When an HMO licenseis suspended, the HMO shall not, during the suspension, enroll any additionalenrollees except newborn children or other newly acquired dependents ofexisting enrollees, and shall not engage in any advertising or solicitation.
(d) When an HMO licenseis revoked, the HMO shall proceed, immediately following the effective date ofthe order of revocation, to wind up its affairs, and shall conduct no furtherbusiness except as may be essential to the orderly conclusion of the affairs ofthe HMO. The HMO shall engage in no advertising or solicitation. The Commissionermay, by written order, permit such further operation of the HMO as theCommissioner may find to be in the best interest of enrollees, to the end thatenrollees will be afforded the greatest practical opportunity to obtaincontinuing health care coverage. (1977, c. 580, s. 1; 1979, c. 876, s. 1; 1997‑519,s. 1.5; 2003‑212, ss. 22, 23, 26(l).)
(a) The Commissionermay suspend or revoke an HMO license if the Commissioner finds that the HMO:
(1) Is operatingsignificantly in contravention of its basic organizational document, or in amanner contrary to that described in and reasonably inferred from any otherinformation submitted under G.S. 58‑67‑10, unless amendments tosuch submissions have been filed with and approved by the Commissioner.
(2) Issues evidences ofcoverage or uses a schedule of premiums for health care services that do notcomply with G.S. 58‑67‑50.
(3) Is no longerfinancially responsible and may reasonably be expected to be unable to meet itsobligations to enrollees or prospective enrollees.
(4) Has itself orthrough any person on its behalf advertised or merchandised its services in anuntrue, misrepresentative, misleading, deceptive or unfair manner.
(5) Is operating in amanner that would be hazardous to its enrollees.
(6) Knowingly orrepeatedly fails or refuses to comply with any law or rule applicable to theHMO or with any order issued by the Commissioner after notice and opportunityfor a hearing.
(7) Has knowinglypublished or made to the Department or to the public any false statement orreport, including any report or any data that serves as the basis for anyreport, required to be submitted under G.S. 58‑3‑191.
(b) A license shall besuspended or revoked only after compliance with G.S. 58‑67‑155.
(c) When an HMO licenseis suspended, the HMO shall not, during the suspension, enroll any additionalenrollees except newborn children or other newly acquired dependents ofexisting enrollees, and shall not engage in any advertising or solicitation.
(d) When an HMO licenseis revoked, the HMO shall proceed, immediately following the effective date ofthe order of revocation, to wind up its affairs, and shall conduct no furtherbusiness except as may be essential to the orderly conclusion of the affairs ofthe HMO. The HMO shall engage in no advertising or solicitation. The Commissionermay, by written order, permit such further operation of the HMO as theCommissioner may find to be in the best interest of enrollees, to the end thatenrollees will be afforded the greatest practical opportunity to obtaincontinuing health care coverage. (1977, c. 580, s. 1; 1979, c. 876, s. 1; 1997‑519,s. 1.5; 2003‑212, ss. 22, 23, 26(l).)
