Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-079 - HEALTH MAINTENANCE ORGANIZATIONS GENERALLY › Section 482-1-079-.15 - Records And Asset Maintenance Of Domestic HMOs

Current through Register Vol. 42, No. 9, June 28, 2024
An Alabama domiciled (domestic) HMO shall keep all necessary
				records in an Alabama location required for the efficient examination of its
				financial condition and health care delivery system. These records shall
				include but not be limited to the general ledger and subsidiary ledgers,
				management contracts, provider contracts, enrollment records, utilization
				records, group contract records, premium records, quality of care documentation
				records, and complaint records.
All original evidences of ownership of assets shall be
				maintained in a suitable Alabama depository and shall be promptly produced upon
				request by the Commissioner or his examiners. The HMO shall make reasonable
				arrangements for the safeguarding of its assets which may include safekeeping
				or trust arrangements with Alabama banks or trust companies.
Every domestic HMO shall have, and maintain, its principal
				place of business and home office in this state and shall keep therein complete
				records of its assets, transactions, and affairs in accordance with such
				methods and systems as are customary or suitable as to the kind, or kinds, of
				business transacted.
Every domestic HMO shall have, and maintain, its assets in this
				state, except as to:
(1) Real property
			 and personal property appurtenant thereto lawfully owned by the HMO and located
			 outside this state; and
(2) Such
			 property of the HMO as may be customary and necessary to enable and facilitate
			 the operation of its branch offices and "regional home offices" located outside
			 this state as long as such records and assets are made readily available at
			 such office for examination by the Commissioner at his request.
Removal of all, or a material part thereof, the records or
				assets of an Alabama domiciled HMO except pursuant to a plan of merger or
				consolidation approved by the Commissioner, or concealment of such records or
				assets, or material part thereof, from the Commissioner is prohibited. Upon any
				removal or attempted removal of such records or assets or upon retention of
				such records or assets, or material part thereof, outside this state beyond the
				period specified in the Commissioner's written consent under which the records
				were so removed or upon concealment of, or attempt to conceal, records or
				assets in violation of this chapter and Section
				27-27-29 supra, the Commissioner
				shall institute delinquency proceedings against the HMO pursuant to the
				provisions of Sections
				27-32-1
et
seq
.
Code of
				Ala. 1975
.
A domestic HMO, for good cause shown and with the written
				permission of the Commissioner, may maintain its executive offices outside the
				State of Alabama provided it keeps an office managed by one or more officers of
				the HMO and keeps a complete duplicate set of records in Alabama and further
				agrees to make all records at the executive offices outside Alabama available
				to the Commissioner upon reasonable notice by him.
Any HMO may evidence ownership of its assets by use of a
				clearing corporation or federal reserve book-entry deposit system by depositing
				acceptable securities through an local bank or trust company with which an
				approved custodial agreement has been executed. For statutory deposits the
				deposit must also be evidenced by a sworn affidavit made by an officer of the
				bank in accordance with Chapter 482-1-077.
Author:
Commissioner of Insurance
Statutory Authority:
Code of Ala.
				  1975
, §§
										27-2-17,
				  27-21A-19.