P.R. Laws tit. 26, § 1918
(1) For the protection of public interest, the Commissioner may carry out, at least every three years, an examination of the affairs of any health organization and providers with which said organization has contracts, agreements or other arrangements under its plans.
(2) For the protection of public interest, the Secretary of Health shall carry out an annual examination relating to the quality of the health services as well as to determine, among other things, the utilization of the services of any health services organization and providers with which said organization has contracted by virtue of its health care plans.
(3) Each health services organization or provider shall submit its books and records relating to the health care plan for examination and shall facilitate such examination. For purposes of examination, the Commissioner and the Secretary of Health may administer oaths and examine the officers and agents of the organization and the officers of the providers related to its business.
(4) The expenses of the examination under this section shall be borne by the organization examined and shall be sent to the Commissioner or the Secretary of Health, depending on who is carrying out the examination, and shall be covered into the general fund of the Commonwealth of Puerto Rico, or as otherwise provided by the Legislature.
(5) In the case of a foreign health services organization, instead of the examination required in subsection (1) of this section, the Commissioner may accept the report of the examination carried out by the Commissioner of the state of the domicile of said organization. The examination relating to the quality of the health services as provided in subsection (2) of this section shall be carried out by the Secretary of Health of Puerto Rico.
History —Ins. Code, added as § 19.180 on June 2, 1976, No. 113, p. 313, § 1.