Missouri

354.010. Definitions.

354.015. Health services corporations, laws applicable to — exceptions.

354.020. Preexisting health services corporation to amend articles, effect of.

354.025. Corporate purposes and authority.

354.027. Discrimination in coverage or reimbursement for covered service by licensed persons, prohibited.

354.030. For-profit corporations excluded from act.

354.035. Procedure for organization of corporation.

354.040. Articles of incorporation, required information and contents.

354.045. Issuance of certificate, effect of.

354.050. General powers of corporation.

354.055. Certificate of authority required — expiration of, extended how.

354.060. Director to issue certificate, when.

354.065. Articles of incorporation, how amended — copy to director, when.

354.070. Certificate of authority automatically extended, when.

354.075. Capital required to do business.

354.080. Reserves required, how computed.

354.085. Membership contract forms, approval by director, when — time for filing — time for disapproval.

354.090. Health services corporation contracts, purposes, parties to.

354.095. Limitation of membership and benefits — certain benefits to be provided, when.

354.105. Annual report required, contents of.

354.115. Member's grievance, how and where filed — director may investigate, court action not barred.

354.120. Rules and regulations by director authorized — procedure, review.

354.125. Corporation not liable for injuries resulting from medical services rendered members.

354.130. Exemption from certain taxes, exceptions.

354.140. Dissolution, liquidation or rehabilitation of corporation, procedure for.

354.145. Appeal from director's actions or decisions, how taken.

354.150. Fees — waiver, when.

354.152. Premiums, dues or fees subject to restrictions — violation, hearing — order prohibiting.

354.155. Disclaimer as to nonhealth services corporations.

354.165. Certain organizations exempt.

354.175. Wage continuation plans by employer exempt.

354.180. Administrative order, director to issue, when.

354.190. Examinations, procedures.

354.195. Records of examination, duty to keep.

354.200. Examinations, false testimony, penalty.

354.205. Examinations — costs, how paid.

354.207. Second medical opinion to be allowed by health services corporations, procedure, costs.

354.210. Director may seek relief, when.

354.215. Examiner's sick leave to apply to health services corporations.

354.220. Director may bring suit to recover fees or sums.

354.225. Enrollment representative, defined — annual report to furnish information — solicitors of members to be insurance agent or broker, exception.

354.230. License required for enrollment representative.

354.235. Enrollment representative — license issued when, qualifications.

354.240. Nonresident may be licensed — examination waived, when.

354.265. Nonrenewable temporary license issued, when.

354.275. Violations by enrollment representatives, penalties.

354.280. Officers of corporation found to be of known bad character or incompetent — authority to transact business, effect.

354.285. Management agreements to control corporation, notice to department, when — examination requirements — violations.

354.290. Examiner's duties — examination contents — hearing on reports allowed — publication of report, when.

354.295. Certificate of authority not to be issued if controlling management involved in improper actions.

354.300. Certificate of authority suspended or revoked, when.

354.305. Corporation advertising assets also to show liabilities — penalties.

354.315. Data processing system authorized, cost, amount allowed — amortization not to exceed ten years.

354.320. Corporate funds and securities use for private gain by officers and employees prohibited, penalty.

354.325. Investigation by director of investments — records to be kept by division — criminal action, when.

354.330. Public official failing to perform duties as to investment violations, penalty.

354.335. Damages allowed if corporation without reasonable cause refuses to pay.

354.340. Unsatisfied judgments against corporation — suspension or revocation of certificate of authority until judgment satisfied.

354.345. Court decree of specific performance — membership contract, failure of corporation to comply, procedure, effect.

354.350. Fraudulent or bad faith conduct — investigation by division — hearing, procedure.

354.355. Injunctions, permanent or temporary, grounds, procedure — dissolution of corporation or rehabilitation, procedure.

354.357. Receivership, grounds, procedure.

354.362. Newborn child coverage required — notice of birth, when, effect.

354.380. Certain provisions of insurance law to be applicable.

354.400. Definitions.

354.405. Certificate of authority, who may make application — foreign corporation may qualify, requirements — procedure.

354.407. PACE projects not deemed health maintenance organizations, when.

354.410. Certificate issued, when — annual deposit, requirements — capital account, amount, contents.

354.415. Powers of organization.

354.420. Advisory panels to afford enrollees participation in policy decisions.

354.425. Bonding of officers who disburse or invest funds — bond requirements.

354.430. Evidence of coverage, requirements — rights of enrollee — toll-free telephone number required.

354.435. Annual reports filed with director, when — content — forms.

354.440. Information to be available to enrollees.

354.441. Disclosures to subscribers shall not be prohibited or restricted.

354.442. Disclosure information to enrollees required, when.

354.443. Financial disclosures to the department required by health maintenance organizations, when.

354.444. Administrative orders for violations — voluntary forfeitures, civil actions.

354.445. Complaints by enrollees, organization to establish system.

354.450. Investments authorized.

354.455. Deposit required, how made.

354.460. Advertising not to be untrue or misleading — deceptive solicitation — prohibited — how determined.

354.462. Enrollee, grounds for disenrollment.

354.464. Names not authorized for use, exceptions.

354.465. Examinations by division, when — costs, how paid.

354.470. Suspension or revocation, when — effect.

354.475. Insurance companies or health service company may organize and operate a health maintenance organization.

354.480. Rehabilitation, liquidation, or conservation, grounds, procedure — enrollee's priorities — claims, priority.

354.485. Rules and regulations authorized.

354.490. Certificate of authority, denial, suspension or revocation, grounds — procedure.

354.495. Fees to be paid to director.

354.500. Conferences called by director as to suspected or potential violations.

354.505. Laws regulating insurance or health service corporations not to apply, exceptions.

354.510. Public documents, all filings and required reports.

354.515. Confidential information, diagnosis, treatment, health of enrollees or applicants, exceptions.

354.520. Mergers, consolidations, control of organization, requirements.

354.525. Health provision collective bargaining agreements or contracts — charge for coverage, how determined.

354.530. Severability clause.

354.530. Severability clause.

354.535. Pharmacist, emergency situation, may take an assignment of enrollee's right to reimbursemen…

354.536. Continuation of dependent child coverage, when — dependent child defined.

354.540. Health maintenance organization of bordering states may be admitted to do business — procedure.

354.545. Exempt plans and companies.

354.546. Second medical opinion to be allowed by health maintenance organizations, procedure, costs.

354.550. Laws not applicable to community health companies.

354.551. Health maintenance organizations may offer point of service (POS) riders, when.

354.552. Community-based health maintenance organizations, requirements.

354.554. Standing referrals for certain members of community-based health maintenance organizations, when.

354.556. Trustees, vacancies, elections.

354.558. Materials provided to prospective purchasers.

354.559. Disclosure to members, restrictions and prohibitions.

354.560. Payment arrangements, department to adopt rules — disclosure of financial arrangements — confidentiality.

354.562. Grievance procedures, rulemaking authority.

354.563. Medicare rules to apply to community-based health maintenance organizations, when.

354.565. Community-based health maintenance organization designation given, when — revocation.

354.567. Community-based health maintenance organizations subject to other laws regarding health maintenance organizations.

354.570. Rulemaking — procedure.

354.600. Definitions.

354.603. Sufficiency of health carrier network, requirements, criteria — access plan filed with the department, when.

354.606. Providers notified of specific covered services, when — hold harmless provision — cessation…

354.609. Termination of a contract, procedure.

354.612. Continuation of care after provider termination, when.

354.615. Referrals to appropriate providers, when.

354.618. Open referral health plans offered, when — definitions — obstetrician/ gynecologist service…

354.621. Intermediary and participating provider requirements.

354.624. Proposed provider contract forms filed with the director — contracts maintained at place of business, available for review, when.

354.627. Liability of a health carrier, when.

354.636. Contract requirements after January 1, 1998.

354.650. Definitions.

354.652. Designation as essential community provider, procedure, qualifications.

354.654. Department of health and senior services, duties — rulemaking authority.

354.656. Inclusion of essential community providers in health care network, exceptions.

354.658. Designation nontransferable, site specific — annual affidavit required — notice of certain changes, required when.

354.700. Definitions.

354.702. Prepaid dental plans, who may offer — certificate of authority required — certain state laws not to apply.

354.703. Director may order violators to cease and desist, hearing — noncompliance, director's remedies.

354.704. Application for certificate of authority, content.

354.705. Certificate of authority granted, when.

354.707. Capital, surplus, security required — cash, securities, bond to be deposited or filed with …

354.710. Reserve requirements — reserve not required for prepaid dental plans funded by government —…

354.712. Contract or contract certificate to be issued to enrollees, content, copy to be filed with …

354.715. Providers of dental care, written contract with prepaid dental plan corporations, review and mediation procedures for enrollees required.

354.717. Director, powers — financial examinations, when, by whom made and paid.

354.720. Annual report, required, content.

354.721. Agents, registration required — rules and regulations authorized.

354.722. Revocation or suspension of certificate of authority, when — notice, civil suit authorized — suspension, revocation, activity permitted.

354.723. Rulemaking authorized.

354.725. Exclusion, labor organization's health plans.