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37-11A-1
by the Governor, or upon its otherwise becoming a law, and when the State of Mississippi ratifies
the compact. Article III. For purposes of this compact, the following terms shall have the
following meanings: (1) Person means an individual, a corporation, a partnership, or any other
entity. (2) Railroad means a common carrier by railroad as defined in Section 1(3) of Part
I of the Interstate Commerce Act [codified as 49 U.S.C. §1(3)]. (3) Railroad properties and
facilities mean any real or personal property or interest in property which is owned,
leased, or otherwise controlled by a railroad or other person, including, without limitation,
the authority, and which are used or are useful in rail transportation service, including,
without limiting the generality of the foregoing: a. Track, roadbed, and related structures,
including rail, ties, ballast, other track materials, grading, tunnels, bridges, trestles,
culverts, elevated structures, stations, office buildings used for operating...
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27-21A-17
Section 27-21A-17 Suspension or revocation of certificate of authority. (a) The commissioner
in consultation with and with the approval of the State Health Officer, where necessary, may
suspend or revoke any certificate of authority issued to a health maintenance organization
under this chapter if he finds that any of the following conditions exist: (1) The health
maintenance organization is operating significantly in contravention of its basic organizational
document or in a manner contrary to that described in any other information submitted under
Section 27-21A-2, unless amendments to such submissions have been filed with the commissioner
and the State Health Officer and approved by the commissioner; (2) The health maintenance
organization issues evidence of coverage or uses a schedule of charges for health care services
which do not comply with requirements of Section 27-21A-7; (3) The health maintenance organization
does not provide or arrange for basic health care services; (4)...
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27-21A-15
Section 27-21A-15 Powers of insurers and health care service plans. (a) An insurance company
licensed in this state, or a health care service plan authorized to do business in this state,
may either directly or through a subsidiary or affiliate organize and operate a health maintenance
organization under the provisions of this chapter. Notwithstanding any other law which may
be inconsistent herewith, any two or more such insurance companies, health care service plans,
or subsidiaries or affiliates thereof, may jointly organize and operate a health maintenance
organization. The business of insurance is deemed to include the providing of health care
by a health maintenance organization owned or operated by an insurer or a subsidiary thereof.
(b) Notwithstanding any provision of insurance and health care service plan laws, Title 10,
Chapter 4, Article 6 and Title 27, an insurer or a health care service plan may contract with
a health maintenance organization to provide insurance or...
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27-21A-23
Section 27-21A-23 Statutory construction and relationship to other laws. (a) Except as otherwise
provided in this chapter, provisions of the insurance law and provisions of health care service
plan laws shall not be applicable to any health maintenance organization granted a certificate
of authority under this chapter. This provision shall not apply to an insurer or health care
service plan licensed and regulated pursuant to the insurance law or the health care service
plan laws of this state except with respect to its health maintenance organization activities
authorized and regulated pursuant to this chapter. (b) Solicitation of enrollees by a health
maintenance organization granted a certificate of authority shall not be construed to violate
any provision of law relating to solicitation or advertising by health professionals. (c)
Any health maintenance organization authorized under this chapter shall not be deemed to be
practicing medicine and shall be exempt from the provisions of...
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27-21A-8
Section 27-21A-8 Reporting requirements. Every health maintenance organization shall annually,
on or before the first day of March, file a report verified by at least two principal officers
with the commissioner, with a copy to the State Health Officer, covering the preceding calendar
year. Such report shall be on forms prescribed by the commissioner, and shall include: (1)
A financial statement of the organization; (2) Any material changes in the information submitted
pursuant to subsection (c) of Section 27-21A-2; (3) The number of persons enrolled at the
beginning and end of the year; (4) A summary of information compiled pursuant to paragraph
(a)(2)c of Section 27-21A-3; (5) The amount of uncovered and covered expenditures that are
payable and more than 90 days past due; and (6) Such additional information or reports as
are deemed reasonably necessary and appropriate by the commissioner to enable him to carry
out his duties under this chapter. (Acts 1986, No. 86-471, p. 854, §8.)...
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27-21A-13
Section 27-21A-13 Prohibited practices. (a) No health maintenance organization, or representative
thereof, may cause or knowingly permit the use of advertising which is untrue or misleading,
solicitation which is untrue or misleading, or any form or evidence of coverage which is deceptive.
For purposes of this chapter: (1) A statement or item of information shall be deemed to be
untrue if it does not conform to fact in any respect which is or may be significant to an
enrollee of, or person considering enrollment with a health maintenance organization; (2)
A statement or item of information shall be deemed to be misleading, whether or not it may
be literally untrue, if, in the total context in which such statement is made or such item
of information is communicated, such statement or item of information may be reasonably understood
by a reasonable person, not possessing special knowledge regarding health care coverage, as
indicating any benefit or advantage or the absence of any...
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27-21A-4
Section 27-21A-4 Powers of health maintenance organizations. (a) The powers of a health maintenance
organization include, but are not limited to the following: (1) The purchase, lease, construction,
renovation, operation, or maintenance of hospitals, medical facilities, or both, and their
ancillary equipment; (2) The making of loans other than in the ordinary course of business,
to providers under contract with it in furtherance of its program or the making of loans to
a corporation or corporations in which it owns a majority interest for the purpose of acquiring
or constructing medical facilities and hospitals or in furtherance of a program providing
health care services to enrollees. (3) The furnishing of health care services through providers
which are under contract with or employed by the health maintenance organization. (4) The
contracting with any person for the performance on its behalf of certain functions such as
marketing, enrollment, and administration. (5) The purchase,...
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35-11-371
persons, firms, or corporations claimed by the injured person, or the legal representative
of the person, to be liable for damages arising from the injuries. The claimant shall also
within one day after the filing of the claim or lien, mail a copy thereof by registered or
certified mail, postage prepaid, for each person, firm, or corporation so claimed to be liable
on account of the injuries, at the addresses so given in the statement, and to the patient,
his or her guardian, or his or her personal representative at the address given at
the time of admission. (d) The filing of a claim or lien shall be notice thereof to all persons,
firms, or corporations liable for damages, whether or not they are named in the claim or lien.
Nothing shall be deemed to preclude the hospital from perfecting its lien outside of the time
limits stated in this section through providing actual notice to persons, firms, or corporations.
(e) The judge of probate shall endorse thereon the date and hour of...
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27-21A-1
organization. (5) EVIDENCE OF COVERAGE. Any certificate, agreement, or contract issued to an
enrollee setting out the coverage to which he is entitled. (6) HEALTH CARE SERVICES. Any services
included in the furnishing to any individual of medical or dental care, or hospitalization
or incident to the furnishing of such care or hospitalization, as well as the furnishing to
any person of any and all other services for the purpose of preventing, alleviating, curing,
or healing human illness, injury, or physical disability. (7) HEALTH MAINTENANCE ORGANIZATION.
Any person that undertakes to provide or arrange for basic health care services through an
organized system which combines the delivery and financing of health care to enrollees. The
organization shall provide physician services directly through physician employees or under
contractual arrangements with either individual physicians or a group or groups of physicians.
The organization shall provide basic health care services...
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27-21A-22
Section 27-21A-22 Penalties and enforcement. (a) The commissioner may, in lieu of suspension
or revocation of a certificate of authority under Section 27-21A-17, levy an administrative
penalty in an amount not less than $500.00 nor more than $5,000.00, if reasonable notice in
writing is given of the intent to levy the penalty and the health maintenance organization
has a reasonable time within which to remedy the defect in its operations which gave rise
to the penalty citation. The commissioner may augment this penalty by an amount equal to the
sum that he calculates to be the damages suffered by enrollees or other members of the public.
All moneys collected under this section shall be deposited to the credit of the General Fund.
(b)(1) If the commissioner or the State Health Officer shall for any reason have cause to
believe that any violation of this chapter has occurred or is threatened, the commissioner
or State Health Officer may give notice to the health maintenance organization...
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