42 U.S.C. § 300e–10 — Restrictive State laws and practices

(a) Entities operating as health maintenance organizations Suppose an entity can't legally operate as an HMO in a state -- because that state's law, regulation, or practice: (A) requires a medical society to approve the entity's services; (B) requires physicians to make up all or part of its governing board; (C) requires all or a percentage of local physicians to be allowed to participate in providing its services; (D) requires it to meet the same capitalization and financial-reserve rules that apply to health insurers in that state; or (E) imposes requirements that would stop it from following this subchapter's rules -- and the entity either received a grant, contract, loan, or loan guarantee under this subchapter, or is a "qualified" HMO under section 300e-9 (relating to employee health benefit plans). In that case, those state requirements don't apply to the entity -- they can't stop it from operating as an HMO under section 300e. (b) Advertising No state may make or enforce a law that stops an HMO -- one that got subchapter funding, or that's a qualified HMO under section 300e-9 -- from advertising to attract members, including advertising its services, charges, or other non-professional parts of its operation. But this doesn't allow advertising that identifies, refers to, or judges the quality of any health professional who works for the HMO. (c) Digest of State laws, regulations, and practices; legal consultative assistance Within 6 months after October 8, 1976, the Secretary must build a digest of state laws, regulations, and practices affecting how HMOs are developed, established, and run. The Secretary must update this digest at least once a year, and send the relevant sections to each state's Governor annually. The digest must flag which state laws, regulations, and practices seem to conflict with this section. The Secretary must also make sure states can get proper legal help to comply with this section.