Iowa Admin. Code r. 191-73.22

Current through Register Vol. 47, No.14, January 8, 2025

Rule 191-73.22 - Grounds for denial, nonrenewal, suspension or revocation of certificate

The following constitute grounds for denial, nonrenewal, suspension or revocation of the HIPC's certificate following notice and an opportunity for hearing:

1. Failure to comply with any provisions of the rules of this chapter;

2. Failure to comply with any lawful order of the commissioner;

3. Committing an unfair or deceptive act or practice as defined in Iowa Code chapter 507B;

4. Filing any necessary form with the division which contains fraudulent information or omission;

5. Misappropriation, conversion, illegal withholding, or refusal to pay over upon proper demand any moneys that belong to a person or health care carrier otherwise not entitled to the HIPC and that have been entrusted to the HIPC in its fiduciary capacity;

6. Failure to demonstrate through clear and convincing evidence that it will extend HIPC services to a significant group of buyers not currently being served by a HIPC; or

7. Failure to demonstrate through clear and convincing evidence that it will reduce the cost, improve the quality, and improve access to or choice of affordable health insurance or health care services.

In addition, the application for certification to be a HIPC may be denied upon a finding by the commissioner that a sufficient number of HIPCs are licensed within a geographic service area and an additional HIPC would adversely affect existing HIPCs.

Iowa Admin. Code r. 191-73.22

Amended by IAB March 14, 2018/Volume XL, Number 19, effective 4/18/2018