354.415. Powers of organization. - Missouri Statutes

Powers of organization.

354.415. 1. The powers of a health maintenance organizationinclude, but are not limited to, the power to:

(1) Purchase, lease, construct, renovate, operate, andmaintain hospitals, medical facilities, or both, and theirancillary equipment, and such property as may reasonably berequired for the organization's principal office or for suchother purposes as may be necessary in the transaction of thebusiness of the organization;

(2) Make loans to a medical group under contract with it infurtherance of its program, or to make loans to any corporationunder its control for the purpose of acquiring or constructingmedical facilities and hospitals or in the furtherance of aprogram providing health care services to enrollees;

(3) Furnish health care services through providers which areunder contract with, or employed by, the health maintenanceorganization;

(4) Contract with any person for the performance, on theorganization's behalf, of certain functions such as marketing,enrollment, and administration;

(5) Contract with an insurance company licensed in thisstate, or with a health services corporation authorized to dobusiness in this state, for the provision of insurance,indemnity, or reimbursement against the cost of health careservices provided by the health maintenance organization;

(6) Offer, in addition to basic health care services:

(a) Additional health care services;

(b) Indemnity benefits covering out-of-area or emergencyservices; and

(c) Indemnity benefits, in addition to those relating toout-of-area and emergency services, provided through insurers orhealth services corporations.

2. Prior to the exercise of any power granted in subdivision(1) or (2) of subsection 1 of this section, involving an amountin excess of five hundred thousand dollars, a health maintenanceorganization shall file notice, with adequate supportinginformation, with the director. The director shall disapprovesuch exercise of power if, in his opinion, it would substantiallyand adversely affect the financial soundness of the healthmaintenance organization and endanger its ability to meet itsobligations. If the director does not disapprove such exerciseof power within sixty days of the filing, it shall be deemedapproved.

3. The director may exempt from the filing requirement ofsubsection 2 of this section those activities having minimaleffect.

(L. 1983 H.B. 127)