2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 4 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 10-16-401 — 10-16-429) › Section 10-16-420 - Penalties and enforcement

(1)
The commissioner may, in lieu of suspension or revocation of a certificate of authority under section
10-16-417
and pursuant to the provisions of article
4
of title
24
, C.R.S., levy an administrative penalty in an amount not less than one hundred dollars nor more than five hundred 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 commissioner may augment this penalty by an amount equal to the sum that the commissioner calculates to be the damages suffered by enrollees or other members of the public.
(2)
(a)
If the commissioner, for any reason, has cause to believe that any violation of part 1 of this article 16 or of this part 4 has occurred or is threatened prior to levy of a penalty or suspension or revocation of a certificate of authority, the commissioner shall 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 violations.
(b)
Proceedings under this subsection (2) are not governed by any formal procedural requirements, and may be conducted in such manner as the commissioner deems appropriate under the circumstances.
(3)
(a)
The commissioner 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 act or practice in violation of the provisions of part 1 of this article or this part 4.
(b)
Within thirty days after service of the order of cease and desist, the respondent may request a hearing on the question of whether acts or practices in violation of part 1 of this article or this part 4 have occurred. Such hearings shall be conducted pursuant to the provisions of article
4
of title
24
, C.R.S.
(4)
In the case of any violation of the provisions of part 1 of this article or this part 4, if the commissioner elects not to issue a cease-and-desist order or in the event of noncompliance with a cease-and-desist order issued pursuant to subsection (3) of this section, the commissioner may institute a proceeding to obtain injunctive relief or seek other appropriate relief through the attorney general.
(5)
Any final action of the commissioner pursuant to this section shall be subject to judicial review by the court of appeals pursuant to section
24-4-106(11)
, C.R.S.
Amended by 2017 Ch. 283,§ 13, eff. 6/1/2017.
L. 92: Entire article R&RE, p. 1710, § 1, effective July 1; (5) added, p. 1600, § 126, effective July 1. L. 94: (1) amended, p. 1630, § 29, effective May 31. L. 2017: (2) amended, (SB 17-249), ch. 283, p. 1547, § 13, effective June 1.
This section is similar to former § 10-17-124 as it existed prior to 1992.