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Pennsylvania Statutes Title 40 P.S. Insurance § 1565. Penalty

Current as of January 01, 2025 | Updated by Findlaw Staff

(a) The commissioner and secretary may suspend or revoke any certificate of authority issued to a health maintenance organization under this act, or, in their discretion, impose a penalty of not more than one thousand dollars ($1,000) for each and every unlawful act committed, if they find that any of the following conditions exist:

(1) that the health maintenance organization is providing inadequate or poor quality care, thereby creating a threat to the health and safety of its subscribers;

(2) that the health maintenance organization is unable to fulfill its contractual obligations to its subscribers;

(3) that the health maintenance organization or any person on its behalf has advertised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner; or

(4) that the health maintenance organization has otherwise failed to substantially comply with this act.

(b) Before the commissioner or secretary, whichever is appropriate, shall take any action as above set forth, he shall give written notice to the health maintenance organization, accused of violating the law, stating specifically the nature of such alleged violation and fixing a time and place, at least ten days thereafter, when a hearing of the matter shall be held. Hearing procedure and appeals from decisions of the commissioner or secretary shall be as provided in Title 2 of the Pennsylvania Consolidated Statutes (relating to administrative law and procedure).

(c) Repealed. 1978, April 28, P.L. 202, No. 53, § 2(a)[1462], effective June 27, 1978.

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Cite this article: FindLaw.com - Pennsylvania Statutes Title 40 P.S. Insurance § 1565. Penalty - last updated January 01, 2025 | https://codes.findlaw.com/pa/title-40-ps-insurance/pa-st-sect-40-1565/

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