10.07.11.12

.12 Inspections.

A. HMO to Be Open for Inspection. An HMO shall be open to inspection by representatives of the Department and by any agency designated by the Department.

B. Frequency of Inspection.

(1) The Department shall inspect each HMO periodically at reasonable times.

(2) The Department shall monitor continuously the health care services of an HMO:

(a) From the time of notice by the Commissioner that the HMO is not operating in a fiscally sound manner; and

(b) Until:

(i) The Commissioner notifies the Department that the HMO is operating in a fiscally sound manner; and

(ii) The Secretary determines that further continuous monitoring is not warranted.

C. Records and Reports. HMO's shall keep records and shall make reports as the Department shall prescribe. All records shall be open to inspection by representatives of the Department.