Nebraska Statutes 44-32,159. Hazardous operation; violations; director; powers
Whenever the director determines that the financial condition of any health maintenance organization is such that its continued operation might be hazardous to its enrollees or creditors or the general public or that it has violated the Health Maintenance Organization Act, he or she may, after notice and hearing, order the health maintenance organization to take such action as may be reasonably necessary to rectify such condition or violation, including, but not limited to, the following:
Terms Used In Nebraska Statutes 44-32,159
- Action: shall include any proceeding in any court of this state. See Nebraska Statutes 49-801
- Director: shall mean the Director of Insurance. See Nebraska Statutes 44-3298
- Health maintenance organization: shall mean any person who undertakes to provide or arrange for the delivery of basic health care services to enrollees on a prepaid basis except for enrollee responsibility for copayments or deductibles. See Nebraska Statutes 44-32,105
- Reinsurance: shall mean a contract by which an insurer procures a third party to insure it against loss or liability by reason of such original insurance. See Nebraska Statutes 44-103
- State: when applied to different states of the United States shall be construed to extend to and include the District of Columbia and the several territories organized by Congress. See Nebraska Statutes 49-801
(1) Reduce the total amount of present and potential liability for benefits by reinsurance or another method acceptable to the director;
(2) Reduce the volume of new business being accepted;
(3) Reduce expenses by specified methods;
(4) Suspend or limit the writing of new business for a period of time;
(5) Increase the health maintenance organization’s capital and surplus by contribution; or
(6) Take such other steps as the director deems appropriate under the circumstances.
The violation by a health maintenance organization of any law of this state to which such health maintenance organization is subject shall be deemed a violation of the act.