IC 27-13-28-1 Augmentation of penalty; damages suffered by enrollees or other
members of the public
Sec. 1. The commissioner may augment a penalty imposed under
IC 27-13-24-1(b) by an amount equal to the sum that the
commissioner calculates to be the damages suffered by enrollees or
other members of the public. The commissioner may direct that any
penalty imposed under this section be paid to the enrollees or other
members of the public damaged by the health maintenance
organization. As added by P.L.26-1994, SEC.25.
IC 27-13-28-2 Conference to determine violations
Sec. 2. If the commissioner has cause to believe that a violation
of this article by a health maintenance organization has occurred or
is threatened, the commissioner may give notice to:
(1) the health maintenance organization; and
(2) the other persons who appear to be involved in the suspected
violation;
to arrange a conference with the alleged violators or their authorized
representatives for the purpose of attempting to determine the facts
relating to the suspected violation and, if a violation has occurred or
is threatened, to determine an adequate and effective means of
correcting or preventing the violation. As added by P.L.26-1994, SEC.25.
IC 27-13-28-3 Procedural requirements
Sec. 3. Proceedings under section 2 of this chapter are not
governed by any formal procedural requirements and may be
conducted in a manner the commissioner considers appropriate under
the circumstances. However, a conference under section 2 of this
chapter may not result in a rule or an order until the requirements of
section 2 of this chapter are satisfied, unless the health maintenance
organization consents to the rule or order. As added by P.L.26-1994, SEC.25.
IC 27-13-28-4 Cease and desist orders
Sec. 4. (a) The commissioner may issue an order directing:
(1) a health maintenance organization; or
(2) a representative of a health maintenance organization;
to cease and desist from engaging in any act or practice that violates
this article.
(b) Within ten (10) days after a cease and desist order is served
under subsection (a), the health maintenance organization or its
representative may request a hearing on the question of whether acts
or practices in violation of this article have occurred. The hearing
must be conducted under IC 4-21.5. As added by P.L.26-1994, SEC.25.
IC 27-13-28-5 Injunctive or other relief
Sec. 5. In the case of a violation of this article, if the
commissioner elects not to issue a cease and desist order, or in the
event of noncompliance with a cease and desist order issued under
section 4 of this chapter, the commissioner may institute a
proceeding to obtain injunctive relief or other appropriate relief in
the Marion County circuit court. As added by P.L.26-1994, SEC.25.
IC 27-13-28-6 Failure to comply with net worth requirements; continued
operation
Sec. 6. Notwithstanding any other provision of this article, if a
health maintenance organization fails to comply with the net worth
requirement of this article, the commissioner may take appropriate
action to assure that the continued operation of the health
maintenance organization will not be hazardous to the enrollees of
the organization. As added by P.L.26-1994, SEC.25.
IC 27-13-28-7 Investigations on behalf of enrollees or providers not precluded
Sec. 7. This article does not preclude the department from
investigating complaints, grievances, or appeals on behalf of
enrollees or providers. As added by P.L.69-1998, SEC.11.
IC 27-13-28-1 Augmentation of penalty; damages suffered by enrollees or other
members of the public
Sec. 1. The commissioner may augment a penalty imposed under
IC 27-13-24-1(b) by an amount equal to the sum that the
commissioner calculates to be the damages suffered by enrollees or
other members of the public. The commissioner may direct that any
penalty imposed under this section be paid to the enrollees or other
members of the public damaged by the health maintenance
organization. As added by P.L.26-1994, SEC.25.
IC 27-13-28-2 Conference to determine violations
Sec. 2. If the commissioner has cause to believe that a violation
of this article by a health maintenance organization has occurred or
is threatened, the commissioner may give notice to:
(1) the health maintenance organization; and
(2) the other persons who appear to be involved in the suspected
violation;
to arrange a conference with the alleged violators or their authorized
representatives for the purpose of attempting to determine the facts
relating to the suspected violation and, if a violation has occurred or
is threatened, to determine an adequate and effective means of
correcting or preventing the violation. As added by P.L.26-1994, SEC.25.
IC 27-13-28-3 Procedural requirements
Sec. 3. Proceedings under section 2 of this chapter are not
governed by any formal procedural requirements and may be
conducted in a manner the commissioner considers appropriate under
the circumstances. However, a conference under section 2 of this
chapter may not result in a rule or an order until the requirements of
section 2 of this chapter are satisfied, unless the health maintenance
organization consents to the rule or order. As added by P.L.26-1994, SEC.25.
IC 27-13-28-4 Cease and desist orders
Sec. 4. (a) The commissioner may issue an order directing:
(1) a health maintenance organization; or
(2) a representative of a health maintenance organization;
to cease and desist from engaging in any act or practice that violates
this article.
(b) Within ten (10) days after a cease and desist order is served
under subsection (a), the health maintenance organization or its
representative may request a hearing on the question of whether acts
or practices in violation of this article have occurred. The hearing
must be conducted under IC 4-21.5. As added by P.L.26-1994, SEC.25.
IC 27-13-28-5 Injunctive or other relief
Sec. 5. In the case of a violation of this article, if the
commissioner elects not to issue a cease and desist order, or in the
event of noncompliance with a cease and desist order issued under
section 4 of this chapter, the commissioner may institute a
proceeding to obtain injunctive relief or other appropriate relief in
the Marion County circuit court. As added by P.L.26-1994, SEC.25.
IC 27-13-28-6 Failure to comply with net worth requirements; continued
operation
Sec. 6. Notwithstanding any other provision of this article, if a
health maintenance organization fails to comply with the net worth
requirement of this article, the commissioner may take appropriate
action to assure that the continued operation of the health
maintenance organization will not be hazardous to the enrollees of
the organization. As added by P.L.26-1994, SEC.25.
IC 27-13-28-7 Investigations on behalf of enrollees or providers not precluded
Sec. 7. This article does not preclude the department from
investigating complaints, grievances, or appeals on behalf of
enrollees or providers. As added by P.L.69-1998, SEC.11.
IC 27-13-28-1 Augmentation of penalty; damages suffered by enrollees or other
members of the public
Sec. 1. The commissioner may augment a penalty imposed under
IC 27-13-24-1(b) by an amount equal to the sum that the
commissioner calculates to be the damages suffered by enrollees or
other members of the public. The commissioner may direct that any
penalty imposed under this section be paid to the enrollees or other
members of the public damaged by the health maintenance
organization. As added by P.L.26-1994, SEC.25.
IC 27-13-28-2 Conference to determine violations
Sec. 2. If the commissioner has cause to believe that a violation
of this article by a health maintenance organization has occurred or
is threatened, the commissioner may give notice to:
(1) the health maintenance organization; and
(2) the other persons who appear to be involved in the suspected
violation;
to arrange a conference with the alleged violators or their authorized
representatives for the purpose of attempting to determine the facts
relating to the suspected violation and, if a violation has occurred or
is threatened, to determine an adequate and effective means of
correcting or preventing the violation. As added by P.L.26-1994, SEC.25.
IC 27-13-28-3 Procedural requirements
Sec. 3. Proceedings under section 2 of this chapter are not
governed by any formal procedural requirements and may be
conducted in a manner the commissioner considers appropriate under
the circumstances. However, a conference under section 2 of this
chapter may not result in a rule or an order until the requirements of
section 2 of this chapter are satisfied, unless the health maintenance
organization consents to the rule or order. As added by P.L.26-1994, SEC.25.
IC 27-13-28-4 Cease and desist orders
Sec. 4. (a) The commissioner may issue an order directing:
(1) a health maintenance organization; or
(2) a representative of a health maintenance organization;
to cease and desist from engaging in any act or practice that violates
this article.
(b) Within ten (10) days after a cease and desist order is served
under subsection (a), the health maintenance organization or its
representative may request a hearing on the question of whether acts
or practices in violation of this article have occurred. The hearing
must be conducted under IC 4-21.5. As added by P.L.26-1994, SEC.25.
IC 27-13-28-5 Injunctive or other relief
Sec. 5. In the case of a violation of this article, if the
commissioner elects not to issue a cease and desist order, or in the
event of noncompliance with a cease and desist order issued under
section 4 of this chapter, the commissioner may institute a
proceeding to obtain injunctive relief or other appropriate relief in
the Marion County circuit court. As added by P.L.26-1994, SEC.25.
IC 27-13-28-6 Failure to comply with net worth requirements; continued
operation
Sec. 6. Notwithstanding any other provision of this article, if a
health maintenance organization fails to comply with the net worth
requirement of this article, the commissioner may take appropriate
action to assure that the continued operation of the health
maintenance organization will not be hazardous to the enrollees of
the organization. As added by P.L.26-1994, SEC.25.
IC 27-13-28-7 Investigations on behalf of enrollees or providers not precluded
Sec. 7. This article does not preclude the department from
investigating complaints, grievances, or appeals on behalf of
enrollees or providers. As added by P.L.69-1998, SEC.11.
