§ 10-16-420 — Penalties and enforcement

Colorado § 10-16-420

• Jurisdiction: Colorado
• Title 10: Insurance
• Art.: Health-care Coverage

Text

(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.

Legislative History

Source: 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.