CHAPTER 23. EXAMINATIONS

IC 27-13-23

    

Chapter 23. Examinations

IC 27-13-23-1

Health maintenance organization examination

    

Sec. 1. The commissioner may make an examination of a health
maintenance organization whenever necessary for the protection of
the interests of the citizens of Indiana. However, an examination of
a health maintenance organization domiciled in Indiana must be
conducted at least once every three (3) years.

As added by P.L.26-1994, SEC.25.

IC 27-13-23-2

Quality management program examination

    

Sec. 2. The commissioner may make an examination concerning
the quality management program of a health maintenance
organization whenever necessary for the protection of the citizens of
Indiana. However, an examination of the quality management
program of a health maintenance organization domiciled in Indiana
must be conducted at least once every three (3) years.

As added by P.L.26-1994, SEC.25.

IC 27-13-23-3

Availability of books and records

    

Sec. 3. Each health maintenance organization that is subject to an
examination under this chapter shall make its books and records, and
the books and records in its custody or control, available for
examination and otherwise facilitate the completion of the
examination.

As added by P.L.26-1994, SEC.25.

IC 27-13-23-4

Officers and agents; oaths and examination by commissioner

    

Sec. 4. When conducting an examination of a health maintenance
organization, the commissioner:

        (1) may administer oaths to; and

        (2) examine;

the officers and agents of the health maintenance organization
concerning the business of the organization.

As added by P.L.26-1994, SEC.25.

IC 27-13-23-5

Expenses of examination

    

Sec. 5. The expenses incurred by the commissioner in conducting
an examination under this chapter must be paid by the health
maintenance organization being examined.

As added by P.L.26-1994, SEC.25.

IC 27-13-23-6

Health maintenance organizations outside Indiana; reports of

other insurance commissioners

    

Sec. 6. Instead of conducting an examination of a health
maintenance organization that is not domiciled in Indiana, the
commissioner may accept the report of an examination made by the
insurance commissioner of another state if the other state is
accredited by the National Association of Insurance Commissioners.

As added by P.L.26-1994, SEC.25.

IC 27-13-23-7

Annual review of HEDIS data

    

Sec. 7. (a) Beginning July 1, 1999, the commissioner shall review
each health maintenance organization's Health Plan Employer Data
and Information Set (HEDIS) data on an annual basis.

    (b) The commissioner may contract with an appropriate entity to
conduct the reviews required under this section.

As added by P.L.69-1998, SEC.9.

IC 27-13-23-8

Filing examination reports of other states

    

Sec. 8. A health maintenance organization shall file a copy of any
examination report filed by the insurance commissioner of another
state during the preceding calendar year with the annual statement
required under IC 27-13-8-1.

As added by P.L.203-2001, SEC.29.