reglab/housing_qa huggingface dataset:
NE Code § 44-32,152 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,152 - Examinations; expenses.

44-32,152.  Examinations; expenses.(1) The Director of Insurance may make an examination of the affairs of any health maintenance organization in accordance with the Insurers Examination Act and any provider with whom such health maintenance organization has contracts, agreements, or other arrangements as often as is reasonably necessary for the protection of the interests of the people of this state. The Department of Health and Human Services may make an examination concerning the quality assurance program of any health maintenance organization and any provider with whom such health maintenance organization has contracts, agreements, or other arrangements as often as is reasonably necessary for the protection of the interests of the people of this state but not less frequently than once every three years.(2) Every health maintenance organization and provider shall submit its books and records for an examination and in every way facilitate the completion of the examination. For the purpose of an examination, the Director of Insurance and the Department of Health and Human Services may administer oaths to and examine the officers and agents of the health maintenance organization and the principals of a provider concerning the business. An examination shall not involve the confidential communications between physicians and patients.(3) The expenses of an examination shall be assessed against the health maintenance organization being examined and remitted to the Director of Insurance or the Department of Health and Human Services for whom the examination is being conducted in the manner provided in the Insurers Examination Act.(4) In lieu of an examination, the Director of Insurance or the Department of Health and Human Services may accept the report of an examination made by the insurance commissioner, insurance director, insurance superintendent, or equivalent official or director of health or equivalent official of another state.Source   Laws 1990, LB 1136, § 61;   Laws 1993, LB 583, § 90;   Laws 1996, LB 1044, § 251;  Laws 2007, LB296, § 190. Cross References  Insurers Examination Act, see section 44-5901.
NE Code § 44-32,153 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,153 - Certificate of authority; suspension, revocation, or denial; grounds.

44-32,153.  Certificate of authority; suspension, revocation, or denial; grounds.If the Director of Insurance finds that any of the conditions listed in this section exist, any certificate of authority issued under the Health Maintenance Organization Act may be suspended or revoked or any application for a certificate of authority may be denied:(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 44-32,117 unless amendments to such submissions have been filed with and approved by the director;(2) The health maintenance organization issues an evidence of coverage or uses a schedule of charges for health care services which does not comply with the requirements of sections 44-32,129 to 44-32,133 and 44-32,149;(3) The health maintenance organization does not provide or arrange for basic health care services;(4) The Department of Health and Human Services certifies to the Director of Insurance that:(a) The health maintenance organization does not meet the requirements of subsection (2) of section 44-32,119; or(b) The health maintenance organization is unable to fulfill its obligations to furnish health care services;(5) The health maintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees;(6) The health maintenance organization has failed to correct, within the time prescribed by section 44-32,154, any deficiency occurring due to such health maintenance organization's prescribed minimum net worth being impaired;(7) The health maintenance organization has failed to implement grievance procedures in a reasonable manner to resolve valid complaints;(8) The health maintenance organization or any person on its behalf has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive, or unfair manner;(9) The continued operation of the health maintenance organization would be hazardous to its enrollees; or(10) The health maintenance organization has otherwise failed substantially to comply with the act.Source   Laws 1990, LB 1136, § 62;   Laws 1996, LB 1044, § 252;  Laws 2007, LB296, § 191.
NE Code § 44-32,154 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,154 - Deficiency in net worth; impaired condition; director; powers.

44-32,154.  Deficiency in net worth; impaired condition; director; powers.(1) Whenever the director finds that the net worth maintained by any health maintenance organization is less than the minimum net worth required to be maintained by section 44-32,138, he or she shall give written notice to the health maintenance organization of the amount of the deficiency and require (a) filing of a plan for correction of the deficiency acceptable to the director and (b) correction of the deficiency within a reasonable time, not to exceed sixty days, unless an extension of time, not to exceed sixty additional days, is granted by the director. Such a deficiency shall be an impairment, and failure to correct the impairment in the prescribed time shall be grounds for suspension or revocation of the certificate of authority or for placing the health maintenance organization in supervision, rehabilitation, liquidation, or conservation.(2) Unless allowed by the director, no health maintenance organization or person acting on its behalf may, directly or indirectly, renew, issue, or deliver any certificate, agreement, or contract of coverage in this state for which a premium is charged or collected when the health maintenance organization writing such coverage is impaired and the impairment is known to the health maintenance organization or such person. The existence of an impairment shall not prevent the issuance or renewal of a certificate, agreement, or contract when the enrollee exercises an option granted under the plan to obtain a new, renewed, or converted coverage.Source  Laws 1990, LB 1136, § 63.
NE Code § 44-32,155 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,155 - Certificate of authority; suspension, revocation, or denial; administrative penalty; procedure.

44-32,155.  Certificate of authority; suspension, revocation, or denial; administrative penalty; procedure.A certificate of authority shall be suspended or revoked, an application for a certificate of authority denied, or an administrative penalty imposed pursuant to section 44-32,164 only after compliance with the requirements of sections 44-32,156 to 44-32,158.Source  Laws 1990, LB 1136, § 64.
NE Code § 44-32,156 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,156 - Suspension, revocation, denial, or administrative penalty; order; hearing.

44-32,156.  Suspension, revocation, denial, or administrative penalty; order; hearing.Suspension or revocation of a certificate of authority, the denial of an application for a certificate, or the imposition of an administrative penalty shall be by written order and shall be sent by the Director of Insurance to the health maintenance organization or applicant by certified or registered mail and to the Department of Health and Human Services. The written order shall state the grounds, charges, or conduct on which the suspension, revocation, denial, or administrative penalty is based. The health maintenance organization or applicant may in writing request a hearing within thirty days from the date of mailing of the order. If no written request is made, such order shall be final upon the expiration of thirty days.Source   Laws 1990, LB 1136, § 65;   Laws 1996, LB 1044, § 253;  Laws 2007, LB296, § 192.
NE Code § 44-32,157 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,157 - Hearing; notice; decision; appeal.

44-32,157.  Hearing; notice; decision; appeal.(1) If the health maintenance organization or applicant requests a hearing pursuant to section 44-32,156, the Director of Insurance shall issue a written notice of hearing and send it to the health maintenance organization or applicant by certified or registered mail and to the Department of Health and Human Services stating:(a) A specific time for the hearing, which may not be less than twenty nor more than thirty days after mailing of the notice of hearing; and(b) A specific place for the hearing, which may be either in Lancaster County or in the county where the health maintenance organization's or applicant's principal place of business is located.(2) If a hearing is requested, the chief executive officer of the Department of Health and Human Services or his or her designated representative shall be in attendance and shall participate in the proceedings. The recommendations and findings of the chief executive officer with respect to matters relating to the quality of health care services provided in connection with any decision regarding denial, suspension, or revocation of a certificate of authority shall be conclusive and binding upon the Director of Insurance.(3) After the hearing or upon failure of the health maintenance organization to appear at such hearing, the Director of Insurance shall take whatever action he or she deems necessary based on written findings and shall mail his or her decision to the health maintenance organization or applicant with a copy to the Department of Health and Human Services. The action of the Director of Insurance and the recommendation and findings of the chief executive officer may be appealed, and the appeal shall be in accordance with the Administrative Procedure Act. The act shall apply to proceedings under this section to the extent it is not in conflict with this section.Source   Laws 1990, LB 1136, § 66;   Laws 1996, LB 1044, § 254;  Laws 2007, LB296, § 193. Cross References  Administrative Procedure Act, see section 84-920.
NE Code § 44-32,158 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,158 - Certificate of authority; suspension or revocation; effect.

44-32,158.  Certificate of authority; suspension or revocation; effect.(1) When the certificate of authority of a health maintenance organization is suspended, the health maintenance organization shall not, during the period of such suspension, enroll any additional enrollees other than newborn children or other newly acquired dependents of existing enrollees and shall not engage in any advertising or solicitation whatsoever.(2) When the certificate of authority of a health maintenance organization is revoked, such health maintenance organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of such health maintenance organization. It shall engage in no further advertising or solicitation whatsoever. The director may, by written order, permit such further operation of the health maintenance organization as he or she finds to be in the best interest of enrollees to the end that enrollees will be afforded the greatest practical opportunity to obtain continuing health care coverage.Source  Laws 1990, LB 1136, § 67.
NE Code § 44-32,159 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,159 - Hazardous operation; violations; director; powers.

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:(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.Source  Laws 1990, LB 1136, § 68.
NE Code § 44-32,160 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,160 - Hazardous operation; violations; uniform standards and criteria; remedies not exclusive.

44-32,160.  Hazardous operation; violations; uniform standards and criteria; remedies not exclusive.The director may set uniform standards and criteria for early warning that the continued operation of any health maintenance organization might be hazardous to its enrollees or creditors or the general public and standards for evaluating the financial condition of any health maintenance organization, which standards shall be consistent with the purposes expressed in section 44-32,159. The remedies and measures available to the director under such section shall be in addition to, and not in lieu of, the remedies and measures available to the director under the Nebraska Insurers Supervision, Rehabilitation, and Liquidation Act.Source  Laws 1990, LB 1136, § 69. Cross References  Nebraska Insurers Supervision, Rehabilitation, and Liquidation Act, see section 44-4862.
NE Code § 44-32,161 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,161 - Supervision, rehabilitation, liquidation, or conservation; grounds and procedure applicable.

44-32,161.  Supervision, rehabilitation, liquidation, or conservation; grounds and procedure applicable.(1) Any supervision, rehabilitation, liquidation, or conservation of a health maintenance organization shall be deemed to be the supervision, rehabilitation, liquidation, or conservation of an insurance company and shall be conducted pursuant to the Nebraska Insurers Supervision, Rehabilitation, and Liquidation Act. The director may apply for an order directing him or her to rehabilitate, liquidate, or conserve a health maintenance organization upon any one or more grounds set out in sections 44-4812 and 44-4817 or when in his or her opinion the continued operation of the health maintenance organization would be hazardous either to the enrollees or to the people of this state. Enrollees shall have the same priority in the event of liquidation or rehabilitation as the law provides to policyholders of an insurer.(2) For purposes of determining the priority of distribution of general assets, claims of enrollees and enrollees' beneficiaries shall have the same priority as established by subdivision (2) of section 44-4842 for policyholders and beneficiaries of insureds of insurance companies. If an enrollee is liable to any provider for services provided pursuant to and covered by the health care plan, that liability shall have the status of an enrollee claim for distribution of general assets. Any provider who is obligated by statute or agreement to hold enrollees harmless from liability for services provided pursuant to and covered by a health care plan shall have the same priority of distribution of the general assets as established by subdivision (5) of section 44-4842.Source   Laws 1990, LB 1136, § 70;  Laws 2002, LB 1139, § 24.  Cross References  Nebraska Insurers Supervision, Rehabilitation, and Liquidation Act, see section 44-4862.
NE Code § 44-32,162 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,162 - Rules and regulations.

44-32,162.  Rules and regulations.The director shall adopt and promulgate rules and regulations to carry out the Health Maintenance Organization Act.Source  Laws 1990, LB 1136, § 71.
NE Code § 44-32,163 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,163 - Fees; distribution.

44-32,163.  Fees; distribution.Every health maintenance organization subject to the Health Maintenance Organization Act shall pay to the director the following fees:(1) For filing an application for a certificate of authority or amendment thereto, three hundred dollars;(2) For filing an amendment to the organizational documents that requires approval, twenty dollars;(3) For filing each annual report, two hundred dollars; and(4) For renewing a certificate of authority, one hundred dollars.Fees charged under this section shall be distributed one-half to the Director of Insurance and one-half to the Department of Health and Human Services. All fees or other assessments transmitted to the Department of Health and Human Services pursuant to the act shall be remitted to the state treasury for credit to the Health and Human Services Cash Fund. There shall be appropriated from money credited to the fund pursuant to this section such amounts as are available to pay expenses considered incident to the administration of the act.Source   Laws 1990, LB 1136, § 72;   Laws 1991, LB 703, § 12;   Laws 1996, LB 1044, § 255;  Laws 2007, LB296, § 194.
NE Code § 44-32,164 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,164 - Administrative penalty.

44-32,164.  Administrative penalty.The director may, in lieu of suspension or revocation of a certificate of authority, levy an administrative penalty in an amount not less than five hundred dollars nor more than ten thousand dollars 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 director may augment a penalty by an amount equal to the sum that he or she calculates to be the damages suffered by enrollees or other members of the public.Source  Laws 1990, LB 1136, § 73.
NE Code § 44-32,165 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,165 - Violations; conference; requirements.

44-32,165.  Violations; conference; requirements.If the Director of Insurance or the Department of Health and Human Services has for any reason cause to believe that any violation of the Health Maintenance Organization Act has occurred or is threatened, the Director of Insurance or the Department of Health and Human Services may give notice to the health maintenance organization and to the representatives or other persons who appear to be involved in such suspected violation to arrange a conference with the alleged violators or their authorized representatives for the purpose of attempting to ascertain the facts relating to such suspected violation and, if it appears that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing such violation. Proceedings under this section shall not be governed by any formal procedural requirements and may be conducted in such manner as the Director of Insurance or the Department of Health and Human Services deems appropriate under the circumstances. Unless consented to by the health maintenance organization, no rule or order may result from a conference until the requirements of this section are satisfied.Source   Laws 1990, LB 1136, § 74;   Laws 1996, LB 1044, § 256;  Laws 2007, LB296, § 195.
NE Code § 44-32,166 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,166 - Cease and desist order; hearing; appeal; injunction.

44-32,166.  Cease and desist order; hearing; appeal; injunction.The director may issue an order directing a health maintenance organization or a representative of a health maintenance organization to cease and desist from engaging in any action or practice in violation of the Health Maintenance Organization Act. Within ten days after service of the cease and desist order, the respondent may request a hearing on the question of whether actions or practices in violation of the act have occurred. Such hearings shall be conducted as provided by the Administrative Procedure Act. The respondent may appeal the decision of the director, and the appeal shall be in accordance with the Administrative Procedure Act. If the director elects not to issue a cease and desist order or in the event of noncompliance with a cease and desist order, the director may institute a proceeding to obtain injunctive or other appropriate relief in the district court of Lancaster County.Source  Laws 1990, LB 1136, § 75. Cross References  Administrative Procedure Act, see section 84-920.
NE Code § 44-32,167 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,167 - Net worth violation; director; powers.

44-32,167.  Net worth violation; director; powers.If a health maintenance organization fails to comply with the net worth requirement of section 44-32,138, the director may take appropriate action to assure that the continued operation of the health maintenance organization will not be hazardous to its enrollees.Source  Laws 1990, LB 1136, § 76.
NE Code § 44-32,168 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,168 - Insurance laws; when applicable.

44-32,168.  Insurance laws; when applicable.Except as otherwise provided in Chapter 44 or the Health Maintenance Organization Act, the insurance laws shall not be applicable to any health maintenance organization granted a certificate of authority under the act. This section shall not apply to an insurer licensed and regulated pursuant to the insurance laws except with respect to its activities authorized and regulated pursuant to the act.Source  Laws 1990, LB 1136, § 77.
NE Code § 44-32,169 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,169 - Solicitation of enrollees; other law; how construed.

44-32,169.  Solicitation of enrollees; other law; how construed.Solicitation of enrollees by a health maintenance organization granted a certificate of authority or its representatives shall not be construed to violate any provision of law relating to solicitation or advertising by health professionals.Source  Laws 1990, LB 1136, § 78.
NE Code § 44-32,170 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,170 - Practice of medicine; laws not applicable.

44-32,170.  Practice of medicine; laws not applicable.Any health maintenance organization authorized under the Health Maintenance Organization Act shall not be deemed to be practicing medicine and shall be exempt from the Medicine and Surgery Practice Act relating to the practice of medicine.Source   Laws 1990, LB 1136, § 79;  Laws 2007, LB463, § 1138. Cross References  Medicine and Surgery Practice Act, see section 38-2001.
NE Code § 44-32,171 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-32,171 - Applications, filings, and reports; public documents; exception.

44-32,171.  Applications, filings, and reports; public documents; exception.All applications, filings, and reports required under the Health Maintenance Organization Act shall be treated as public documents except those which are trade secrets or privileged or confidential quality assurance, commercial, or financial information other than any annual financial statement that may be required under section 44-32,134.Source  Laws 1990, LB 1136, § 80.