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  • PART I ADMINISTRATION OF THE GOVERNMENT
  • TITLE XXII CORPORATIONS
  • CHAPTER 176B MEDICAL SERVICE CORPORATIONS
  • Section 9 Inspection and examination of affairs of corporation; inability to pay providers; pro rata payments; termination of contract

Section 9. The commissioner, or any deputy examiner or any other person designated by the commissioner, shall, at least once in three years, and whenever the commissioner deems it prudent, visit any medical service corporation and examine into its affairs. The commissioner shall have free access to all of the books, records and papers of the corporation, and may summon and examine under oath its officers, agents, employees and other persons in relation to its affairs and condition. The commissioner shall require every such corporation to keep its books, records, accounts and vouchers in such manner that he or his authorized representatives may readily verify its annual statements and determine whether the corporation has complied with the law.

If, at any time, the commissioner determines the corporation is unable to pay a participating physician or other participating professional provider of health services, the participating physician or other participating professional provider of health services shall accept payment on a pro rata basis as determined by the commissioner and shall not be allowed to charge the patient any additional amount for such services. In such case, and notwithstanding the provisions of the third paragraph of section seven, the participating physician or other participating professional provider of health services may give written notice of intent to terminate the provider agreement. Termination under this paragraph shall be effective on the ninety-first day after written notice of intent to terminate is given to the corporation and the commissioner. The corporation may not invoke the so-called “unit system” unless the commissioner has first made the determinations required under this paragraph.