42 USC 300e-10 - Restrictive State laws and practices

U.S Code last checked for updates: May 03, 2024

§ 300e–10.

Restrictive State laws and practices

(a)

Entities operating as health maintenance organizations

In the case of any entity—

(1)

which cannot do business as a health maintenance organization in a State in which it proposes to furnish basic and supplemental health services because that State by law, regulation, or otherwise—

(A)

requires as a condition to doing business in that State that a medical society approve the furnishing of services by the entity,

(B)

requires that physicians constitute all or a percentage of its governing body,

(C)

requires that all physicians or a percentage of physicians in the locale participate or be permitted to participate in the provision of services for the entity,

(D)

requires that the entity meet requirements for insurers of health care services doing business in that State respecting initial capitalization and establishment of financial reserves against insolvency, or

(E)

imposes requirements which would prohibit the entity from complying with the requirements of this subchapter, and

(2)

for which a grant, contract, loan, or loan guarantee was made under this subchapter or which is a qualified health maintenance organization for purposes of section 300e–9 of this title (relating to employees’ health benefits plans),

such requirements shall not apply to that entity so as to prevent it from operating as a health maintenance organization in accordance with section 300e of this title.

(b)

Advertising

(c)

Digest of State laws, regulations, and practices; legal consultative assistance

(July 1, 1944, ch. 373, title XIII, § 1311, as added Pub. L. 93–222, § 2, Dec. 29, 1973, 87 Stat. 931

cite as: 42 USC 300e-10