§ 27-41-18. Rehabilitation, liquidation, or conservation of health maintenance organization.
(a) Any rehabilitation, liquidation, or conservation of a health maintenance organization
shall be deemed to be the rehabilitation, liquidation, or conservation of an insurance
company and shall be conducted under the supervision of the director of business regulation
pursuant to chapters 14.1, 14.2, and 14.3 of this title. The director of business
regulation may apply for an order from the superior court directing the director to
rehabilitate, liquidate, or conserve a health maintenance organization upon any one
or more of the grounds included in chapter 14.3 of this title or upon any one or more
of the following grounds:
(1) That the health maintenance organization is insolvent;
(2) That the health maintenance organization is in an unsound financial condition;
(3) That the health maintenance organization's business policies are unsound or improper;
(4) That the health maintenance organization's condition or management is such as to render
its further transaction of business hazardous to the public or its enrollees;
(5) That the health maintenance organization's funds, net cash, or contingent assets are
deficient; or
(6) That the health maintenance organization is conducting its business fraudulently or
refuses or neglects to comply with the laws of this state.
(b) A claim by a healthcare provider who agrees not to assert that claim against any enrollee
of the health maintenance organization for an uncovered expenditure has priority over
other providers of services.
(c) For purposes of determining the priority of distribution of general assets, claims
of enrollees and enrollees' beneficiaries shall have the same priority as established
in chapter 14.3 of this title for policyholders and beneficiaries of insureds of insurance
companies. If an enrollee is liable to a provider for services provided pursuant to
and covered by the health benefit plan, that liability shall have the status of an
enrollee claim for distribution of general assets. A provider who is obligated by
statute or agreement to hold enrollees harmless from liability for services provided
pursuant to and covered by a health benefit plan shall have a priority of distribution
of the general assets immediately following that of enrollees and enrollees' beneficiaries
as described herein, and immediately preceding the priority of distribution for priority
Class 7 described in § 27-14.3-46.