Virginia Code 38.2-4315: Examinations
A. The Commission shall examine the affairs of each health maintenance organization as provided for in § 38.2-1317 at least once every five years. The Commission may examine the affairs of providers with whom any health maintenance organization has contracts, agreements, or other arrangements according to its health care plan as often as it considers necessary for the protection of the interests of the people of this Commonwealth.
Terms Used In Virginia Code 38.2-4315
- Commission: means the State Corporation Commission. See Virginia Code 38.2-100
- Health care plan: means any arrangement in which any person undertakes to provide, arrange for, pay for, or reimburse any part of the cost of any health care services. See Virginia Code 38.2-4300
- Health maintenance organization: means any person who undertakes to provide or arrange for one or more health care plans. See Virginia Code 38.2-4300
- Oversight: Committee review of the activities of a Federal agency or program.
- State: means any commonwealth, state, territory, district or insular possession of the United States. See Virginia Code 38.2-100
B. Instead of making its own examination, the Commission may accept the report of an examination of a foreign health maintenance organization certified by the insurance supervisory official, similar regulatory agency, or the state health commissioner of another state.
C. The Commission shall coordinate such examinations with the State Health Commissioner to ensure an appropriate level of regulatory oversight and to avoid any undue duplication of effort or regulation.
1980, c. 720, § 38.1-879; 1986, c. 562; 1990, c. 224; 1997, c. 688.