State RegulationsVA specificDifficulty 1/5
Beyond the statutes governing health maintenance organizations, Virginia has adopted detailed administrative rules for HMO operations. Which authority issues those rules?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Virginia's HMO rules are administrative regulations adopted by the State Corporation Commission and published in the Virginia Administrative Code — for HMOs, the rules appear at 14 VAC 5-211-10-280, implementing the statutory framework of Va. Code § 38.2-4300 and related sections. This means HMO operations in Virginia are governed by a combination of statute and Commission-adopted regulation, both administered through the Virginia Bureau of Insurance. Neither a federal agency nor a private industry body issues binding Virginia insurance regulations.
Why the other options are wrong
- A) Federal health agencies do not issue Virginia's HMO insurance regulations; the rules come from the State Corporation Commission in the Virginia Administrative Code.
- B) An HMO's board governs its own company but has no authority to adopt regulations binding the rest of the market.
- C) Private association guidelines are voluntary professional materials, not enforceable Virginia administrative rules.
Memory hook
Virginia's Commission writes the HMO rulebook — find it in the Virginia Administrative Code.