Surveys Of Health Maintenance Organizations

The Commissioner of Health or the Commissioner’s designee may make an examination concerning a health maintenance organization’s capability to provide health care services efficiently, effectively and economically, and any providers with whom such organization has contracts, agreements, or other arrangements as often as is reasonably necessary for the protection of the interests of the people of this state. Such examinations of health maintenance organizations shall occur not less frequently than once every three (3) years and shall occur whenever necessary to respond to complaints from the public or whenever the Department determines that it is in the best interest of the public health and safety. The Commissioner of Health shall report findings to the Commissioner of Commerce and Insurance, who may then suspend or revoke a certificate of authority issued to the health maintenance organization as provided in T.C.A. § 56-32-216.