§ 27-13-24-3 — Procedures; written order; revised application; hearing

Indiana § 27-13-24-3

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 13: HEALTH MAINTENANCE ORGANIZATIONS
• Ch. 24: Suspension, Revocation, or Denial of Certificate of

Text

(a) The commissioner may:
(1) suspend or revoke a certificate of authority;
(2) deny an application for a certificate of authority; or
(3) impose an administrative penalty;
under this article only after complying with this section.
(b) The commissioner may:
(1) suspend or revoke a certificate of authority;
(2) deny an application for a certificate of authority; or
(3) impose an administrative penalty;
under this section by written order that shall be sent to the health
maintenance organization or applicant by certified or registered mail.
In the case of an application for a certificate of authority, the written
order must be sent within one hundred twenty (120) days after the
submission of a completed application. Failure by the commissioner to
issue an order within the one hundred twenty (120) day period
constitutes approval of the application for a certificate of authority. The
written order must state the grounds, charges, or conduct on which the
suspension, revocation, denial, or administrative penalty is based. The
health maintenance organization or applicant may in writing request a
hearing within thirty (30) days after the date of the mailing of the order.
If a written request is not made, the order is final upon expiration of the
thirty (30) days.
(c) If an order is issued under subsection (b) denying an application
for a certificate of authority, the applicant may initiate the following
procedure:
(1) The applicant may submit to the commissioner a revised
application or any other information or material addressing the
reasons the commissioner denied the application. A revised
application and other information submitted to the commissioner
under this subdivision must be submitted within thirty (30) days
after receiving the order, unless the applicant requests an
extension of time from the commissioner, who may not
unreasonably deny the request.
(2) Upon receiving an applicant's revised application or other
information or materials as described in subdivision (1), the
commissioner shall promptly review the materials regardless of
whether the applicant has requested a hearing under subsection
(b).
(3) An applicant's submission of a revised application or other
information or materials is considered to correct and resolve the
reasons for denying the original application for a certificate of
authority. The application or revised application is considered to
be approved unless the commissioner notifies the applicant in
writing by certified or registered mail, within fifteen (15) business
days after the date the submission under subdivision (1) is made,
that the application or revised application is not approved. A
written notification under this subdivision must state in detail the
reasons for continuing to deny the application or the revised
application.
(d) If the health maintenance organization or applicant requests a
hearing under this chapter, the commissioner shall issue a written
notice of hearing and send the notice to the health maintenance
organization or applicant by certified or registered mail. The notice
must contain a specific date and time for the hearing, which may not be
less than twenty (20) days or more than sixty (60) days after the
mailing of the notice of hearing.

Legislative History

As added by P.L.26-1994, SEC.25. Amended by P.L.195-1996, SEC.8.