reglab/housing_qa huggingface dataset:
LA Rev Stat § 22:262 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§262. Technical advice, advisors, and other technical services

RS 262 - Technical advice, advisors, and other technical services A. The commissioner or the secretary may at any time call upon any other state agency, to serve as an advisor on technical or health care matters and for such technical data, statistics, or other information as he may from time to time require in the administration and enforcement of this Subpart. B. In the event it is necessary for the commissioner or secretary to invoke or defend any legal proceedings arising hereunder or with respect hereto, the attorney general of the state shall serve as legal counsel of record for the commissioner or secretary. C. Every health maintenance organization which has been licensed under this Subpart shall submit to the commissioner a plan for accreditation under an organization or entity recognized by the commissioner. The commissioner shall be authorized to make an inspection no less frequently than once every three years of each health maintenance organization, which has not been accredited by an organization or entity recognized by the commissioner, to determine whether it is adhering to the minimum standards for utilization review and grievances. The commissioner shall be authorized to establish agreements with the secretary for review of such health maintenance organization's contractual providers and the quality of services it offers and provides to its enrollees. Within thirty days after inspection, the secretary shall transmit a report of such inspection to the governor with a copy thereof transmitted to the commissioner. The costs of all such inspections shall be assessed as regulatory costs by the commissioner. Acts 1986, No. 1065, §1; Acts 1997, No. 238, §1, eff. June 16, 1997; Redesignated from R.S. 22:2017 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2009, No. 503, §1.
LA Rev Stat § 22:264 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§264. Restriction on alienations or transfers of certificate of authority

RS 264 - Restriction on alienations or transfers of certificate of authority A certificate of authority shall not be disposed of, sold, transferred, or utilized by any person other than the applicant except as authorized by the commissioner. An aggrieved party affected by the commissioner's decision, act, or order may demand a hearing in accordance with Chapter 12 of this Title, R.S. 22:2191 et seq. Acts 1986, No. 1065, §1; Redesignated from R.S. 22:2019 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2009, No. 317, §1.
LA Rev Stat § 22:264.1 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§264.1. Prior approval required for merger of domestic health maintenance organization

RS 264.1 - Prior approval required for merger of domestic health maintenance organization  No domestic health maintenance organization shall merge with another person without the prior approval of the commissioner, who may grant such approval upon written request of a domestic health maintenance organization. The request shall include the articles or plan of merger, a pro-forma consolidated financial statement for the merging entities, and such other information as the commissioner may require to determine that the merger is not detrimental to the enrollees or to the financial solvency of the health maintenance organization. If the merger may result in a change of control of a domestic health maintenance organization, the requirements of this Section may be consolidated with those of R.S. 22:691.4.  Acts 2016, No. 379, §1.
LA Rev Stat § 22:265 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§265. Confidentiality of medical information

RS 265 - Confidentiality of medical information  A. Any data or information pertaining to the diagnosis, treatment, or health of any enrollee or potential enrollee obtained from such persons or from any provider by any health maintenance organization shall be held in confidence and shall not be disclosed to any person except:  (1) To the extent that it may be necessary to carry out the purposes of this Subpart or as otherwise permitted by law. (2) Upon the express consent of the enrollee or potential enrollee. (3) Pursuant to statute or court order for the production of evidence or the discovery thereof. (4) In the event of a claim or litigation between such person and the health maintenance organization, wherein such data or information is pertinent. B. A health maintenance organization shall be entitled to claim any statutory privileges against such disclosure which the provider who furnished such information to the health maintenance organization is entitled. Acts 1986, No. 1065, §1; Redesignated from R.S. 22:2020 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:266 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§266. Medical necessity review

RS 266 - Medical necessity review Every health maintenance organization shall assure full compliance with Subpart F of Part III of Chapter 4 of this Title, R.S. 22:1121 et seq., in establishing procedures for continuous review of quality of care, performance of providers, utilization of health services, facilities, and costs. The medical necessity review requirements and administrative treatment guidelines of the health maintenance organization shall not fall below the appropriate standard of care and shall not impinge upon the independent medical judgment of the treating health care provider. Nothing in this Section shall be construed to prevent a health maintenance organization from conducting a medical necessity review and quality assurance program. Acts 1986, No. 1065, §1; Acts 1997, No. 238, §1, eff. June 16, 1997; Acts 1997, No. 1324, §1; Acts 1999, No. 401, §1, eff. Jan. 1, 2000; Redesignated from R.S. 22:2021 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2009, No. 503, §1.
LA Rev Stat § 22:267 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§267. Enrollee grievance procedure

RS 267 - Enrollee grievance procedure A. Every health maintenance organization shall establish and maintain a grievance system approved by the commissioner under which enrollees may submit their grievances to the health maintenance organization. Each system shall provide reasonable procedures which shall insure adequate consideration of enrollee grievances and rectification when appropriate. B. Every health maintenance organization shall inform its subscribers and enrollees upon enrollment in the health maintenance organization and annually thereafter of the procedure for processing and resolving grievances. Such information shall include the location and telephone number where grievances may be submitted. C. The health maintenance organization shall keep in its files all copies of complaints, and the responses thereto, for a period of five years. D. The commissioner, in compliance with the Louisiana Administrative Procedure Act, R.S. 49:950 et seq., shall be authorized to issue such rules, regulations, and orders as shall be necessary to implement procedures that assure that plan members and participating providers have the opportunity for the appropriate resolution of their grievances. Accreditation by a nationally recognized accrediting body or entity recognized by the commissioner shall be evidence of meeting the requirements of this Section. Acts 1986, No. 1065, §1; Acts 1997, No. 238, §1, eff. June 16, 1997; Redesignated from R.S. 22:2022 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2009, No. 317, §1.
LA Rev Stat § 22:268 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§268. Reports to the governor

RS 268 - Reports to the governor  The secretary and the commissioner each shall report annually to the governor on the activities of his office with respect to health maintenance organizations and shall make such suggestions for change or improvement as may be in the best interest of the state and the industry. Acts 1986, No. 1065, §1; Redesignated from R.S. 22:2023 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:269 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§269. Fees

RS 269 - Fees  A. The following fees shall be collected in advance by the secretary of state for health maintenance organization:  (1) For filing a charter, other documents, and  amendments thereto, per page $ 2.50  (2) For certified copies of any document,  per page $ 2.00  B. The following fees and licenses shall be collected in advance by the commissioner of insurance for health maintenance organizations:  (1) Certificates of authority $ 500.00  (2) Repealed by Acts 2012, No. 206, §1.  (3) (a) For filing annual statement 250.00  (b) Penalty for unauthorized late filing 1,000.00  (4) Initial examination of health maintenance  organization companies 1,000.00  (5) Repealed by Acts 2012, No. 206, §1.  (6), (7) Repealed by Acts 1996, 1st Ex. Sess., No. 71, §2, eff. May 10, 1996.  (8) The commissioner may assess additional  regulatory fees due to costs incurred by the  Louisiana Department of Insurance.  Acts 1986, No. 1065, §1; Acts 1996, 1st Ex. Sess., No. 71, §2, eff. May 10, 1996; Acts 2001, No. 161, §1; Redesignated from R.S. 22:2024 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2012, No. 206, §1.
LA Rev Stat § 22:270 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§270. Repealed by 2016 2nd Ex. Sess., No. 1, §2, eff. June 22, 2016.

RS 270 - Repealed by 2016 2nd Ex. Sess., No. 1, §2, eff. June 22, 2016.
LA Rev Stat § 22:271 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§271. Enrollment application; required statement; annual notification and disclosure of information

RS 271 - Enrollment application; required statement; annual notification and disclosure of information A. Every application for enrollment in a health maintenance organization shall contain the following statement conspicuously displayed on the front of such application in at least ten point bold-face capital letters:  "NOTICE - YOU MUST PERSONALLY BEAR ALL COSTS IF YOU UTILIZE HEALTH CARE NOT AUTHORIZED BY THIS PLAN OR PURCHASE DRUGS WHICH ARE NOT AUTHORIZED BY THIS PLAN." B. The commissioner shall assess a penalty if he determines that a health maintenance organization's enrollment application or annual notices do not contain the language required in this Section. Any insurer violation of this Section shall be considered an unfair trade practice and subject to the penalties provided for under R.S. 22:1969. C. Every subscriber and enrollee shall at the time of enrollment and annually thereafter be provided with a written notice which fully explains copayment and deduction amounts applicable to each covered service. Any separate deductible amounts shall be fully disclosed. The written notice shall be printed in ten-point or larger type and shall outline any limitations on the choice of primary care physicians, access to specialists, and application of preexisting medical condition exclusions from coverage. D. Every subscriber, enrollee, and participating provider shall be provided with an annual plan notification statement which provides: (1) A listing of compensation mechanisms utilized to pay providers including incentive arrangements. (2) A description of the services or treatments which will be covered under the plan. (3) A statement regarding the coverage of experimental treatments. (4) A statement regarding the coverage of prescription drugs. Such statement shall include the procedure used for adding or deleting coverage of specific prescribed drugs. Acts 1989, No. 695, §1, eff. Jan 1, 1990; Acts 1997, No. 238, §1, eff. June 16, 1997; Redesignated from R.S. 22:2026 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:281 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§281. Fraternal benefit societies

RS 281 - Fraternal benefit societies  A fraternal benefit society is any incorporated society, order, or supreme lodge, without capital stock, including one exempted under the provisions of R.S. 22:317(A)(2), whether incorporated or not, conducted solely for the benefit of its members and their beneficiaries and not for profit, operated on a lodge system with ritualistic form of work, having a representative form of government, and which provides benefits in accordance with this Subpart. Acts 1958, No. 125; Acts 1987, No. 470, §1, eff. Jan. 1, 1988; Redesignated from R.S. 22:541 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:282 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§282. Lodge system defined

RS 282 - Lodge system defined  A. A society is operating on the lodge system if it has a supreme governing body and subordinate lodges into which members are elected, initiated, or admitted in accordance with its laws, rules, and ritual. Subordinate lodges shall be required by the laws of the society to hold regular meetings at least once each month in furtherance of the purposes of the society. B. A society may, at its option, organize and operate lodges for children under the minimum age for adult membership. Membership and initiation in local lodges shall not be required of such children, nor shall they have a voice or vote in the management of the society. Acts 1958, No. 125; Acts 1987, No. 470, §1, eff. Jan. 1, 1988; Redesignated from R.S. 22:542 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:283 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§283. Representative form of government defined

RS 283 - Representative form of government defined  A. A society has a representative form of government when all of the following requirements are met:  (1) It has a supreme governing body constituted in one of the following ways:  (a) Assembly. The supreme governing body is an assembly composed of delegates elected directly by the members or at intermediate assemblies or conventions of members or their representatives, together with other delegates as may be prescribed in the society's laws. A society may provide for election of delegates by mail. The elected delegates shall constitute a majority in number of the total delegates, and shall not have less than a majority of the votes and not less than the number of votes required to amend the society's laws. The assembly shall be elected, shall meet at least once every four years, and shall elect a board of directors to conduct the business of the society between meetings of the assembly. Vacancies on the board of directors between elections may be filled in the manner prescribed by the society's laws. (b) Direct Election. The supreme governing body is a board composed of persons elected by the members, either directly or by their representatives in intermediate assemblies, and any other persons prescribed in the society's laws. A society may provide for election of the board by mail. Each term of a board member shall not exceed four years. Vacancies on the board between elections shall be filled in the manner prescribed by the society's laws. Those persons elected to the board shall constitute a majority in number and not less than the number of votes required to amend the society's laws. A person filling the unexpired term of an elected board member shall be considered to be an elected member. The board shall meet at least quarterly to conduct the business of the society. (2) The officers of the society are elected either by the supreme governing body or by the board of directors. (3) Only benefit members are eligible for election to the supreme governing body, the board of directors, or any intermediate assembly. (4) Each voting member shall have one vote; no vote shall be cast by proxy. Acts 1958, No. 125; Acts 1987, No. 470, §1, eff. Jan. 1, 1988; Redesignated from R.S. 22:543 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:284 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§284. General definitions

RS 284 - General definitions  As used in this Subpart, the following terms shall have the meanings herein given to each unless the context clearly indicates otherwise:  (1) "Benefit contract" means the agreement for provision of benefits authorized by R.S. 22:296, as that agreement is described in R.S. 22:299(A). (2) "Benefit member" means an adult member who is designated by the laws or rules of the society to be a benefit member under a benefit contract. (3) "Certificate" means the document issued as written evidence of the benefit contract. (4) "Laws" means the society's articles of incorporation, constitution, and bylaws, however designated. (5) "Lodge" means subordinate member units of the society, known as camps, courts, councils, branches, or by any other designation. (6) "Premiums" means premiums, rates, dues, or other required contributions by whatever name known, which are payable under the certificate. (7) "Rules" means all rules, regulations, or resolutions adopted by the supreme governing body or board of directors which are intended to have general application to the members of the society. (8) "Society" means fraternal benefit society. Acts 1987, No. 470, §1, eff. Jan. 1, 1988; Redesignated from R.S. 22:544 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:285 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§285. Purposes and powers

RS 285 - Purposes and powers  A. A society shall operate for the benefit of members and their beneficiaries by:  (1) Providing benefits as specified in R.S. 22:296. (2) Operating for one or more social, intellectual, educational, charitable, benevolent, moral, fraternal, patriotic, or religious purposes for the benefit of its members, which may also be extended to others. Such purposes may be carried out directly by the society, or indirectly through subsidiary corporations or affiliated organizations. B. Every society shall have the power to adopt laws and rules for the government of the society, the admission of its members, and the management of its affairs. It shall have the power to change, alter, add to, or amend such laws and rules and shall have such other powers as are necessary and incidental to carry into effect the objects and purposes of the society. Acts 1987, No. 470, §1, eff. Jan. 1, 1988; Redesignated from R.S. 22:545 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:286 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§286. Qualifications for membership

RS 286 - Qualifications for membership  A. A society shall specify in its laws or rules:  (1) Eligibility standards for each class of membership, provided that if benefits are provided on the lives of children, the minimum age for adult membership shall be set at not less than age fifteen and not greater than age twenty-one. (2) The process for admission to membership for each membership class. (3) The rights and privileges of each membership class, provided that only benefit members shall have the right to vote on the management of the insurance affairs of the society. B. A society may also admit social members who shall have no voice or vote in the management of the insurance affairs of the society. C. Membership rights in the society are personal to the member and are not assignable. Acts 1958, No. 125. Amended by Acts 1972, No. 768, §7; Acts 1987, No. 470, eff. Jan. 1, 1988; Redesignated from R.S. 22:546 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:287 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§287. Location of office, meetings, communications to members, grievance procedures

RS 287 - Location of office, meetings, communications to members, grievance procedures  A. The principal office of any domestic society shall be located in this state. The meetings of its supreme governing body may be held in any state, district, province, or territory wherein such society has at least one subordinate lodge, or in such other location as determined by the supreme governing body, and all business transacted at such meetings shall be as valid in all respects as if such meetings were held in this state. The minutes of the proceedings of the supreme governing body and of the board of directors shall be in the English language. B.(1) A society may provide in its laws for an official publication in which any notice, report, or statement required by law to be given to members, including notice of election, may be published. Such required reports, notices, and statements shall be printed conspicuously in the publication. If the records of a society show that two or more members have the same mailing address, an official publication mailed to one member is deemed to be mailed to all members at the same address unless a member requests a separate copy. (2) Not later than June first of each year, a synopsis of the society's annual statement providing an explanation of the facts concerning the condition of the society thereby disclosed shall be printed and mailed to each benefit member of the society or, in lieu thereof, such synopsis may be published in the society's official publication. C. A society may provide in its laws or rules for grievance or complaint procedures for members. Acts 1987, No. 470, §1, eff. Jan. 1, 1988; Redesignated from R.S. 22:547 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.