§ 514B.4 — Applicant for certificate of authority

Iowa § 514B.4

• Jurisdiction: Iowa
• Title XIII: COMMERCE
• Ch. 514B: HEALTH MAINTENANCE ORGANIZATIONS

Text

1. The commissioner shall determine whether the applicant for a certificate of authority,
with respect to health care services to be furnished:
a. Has demonstrated the willingness and potential ability to assure the availability,
accessibility, and continuity of service through adequate personnel and facilities.
b. Has arrangements established in accordance with rules adopted by the commissioner
for a continuous review of health care processes and outcomes. If a health maintenance
organization is accredited by the national committee on quality assurance, or another
accreditation entity approved by the commissioner, an external peer review under rules of
the commissioner shall not be applicable. However, at the discretion of the commissioner,
an on-site inspection of the health maintenance organization may be conducted.
c. Has a procedure established in accordance with rules adopted by the commissioner
to develop, compile, evaluate, and report statistics relating to the cost of its operations, the
pattern of utilization of its services, the availability and accessibility of its services, and other
matters as may be reasonably required by the commissioner.
2. Thecommissioner,inadministeringthissectionandsections514B.25and514B.26,may
contract with qualified persons to make recommendations concerning the determinations
5 HEALTH MAINTENANCE ORGANIZATIONS, §514B.5
required to be made by the commissioner. Such recommendations may be accepted in full or
in part by the commissioner.

Legislative History

[C75, 77, 79, 81, §514B.4]