US Code

Public Law 119-102 (07/12/2026)

42 U.S.C. § 300e–10

Restrictive State laws and practices

Section text and notes

(a)

Entities operating as health maintenance organizations

In the case of any entity—
(1)
which cannot do business as a health maintenance organization in a State in which it proposes to furnish basic and supplemental health services because that State by law, regulation, or otherwise—
(A)
requires as a condition to doing business in that State that a medical society approve the furnishing of services by the entity,
(B)
requires that physicians constitute all or a percentage of its governing body,
(C)
requires that all physicians or a percentage of physicians in the locale participate or be permitted to participate in the provision of services for the entity,
(D)
requires that the entity meet requirements for insurers of health care services doing business in that State respecting initial capitalization and establishment of financial reserves against insolvency, or
(E)
imposes requirements which would prohibit the entity from complying with the requirements of this subchapter, and
(2)
section 300e–9 of this title for which a grant, contract, loan, or loan guarantee was made under this subchapter or which is a qualified health maintenance organization for purposes of (relating to employees’ health benefits plans),
section 300e of this titlesuch requirements shall not apply to that entity so as to prevent it from operating as a health maintenance organization in accordance with .
(b)

Advertising

section 300e–9 of this titleNo State may establish or enforce any law which prevents a health maintenance organization for which a grant, contract, loan, or loan guarantee was made under this subchapter or which is a qualified health maintenance organization for purposes of (relating to employees’ health benefits plans), from soliciting members through advertising its services, charges, or other nonprofessional aspects of its operation. This subsection does not authorize any advertising which identifies, refers to, or makes any qualitative judgement concerning, any health professional who provides services for a health maintenance organization.

(c)

Digest of State laws, regulations, and practices; legal consultative assistance

The Secretary shall, within 6 months after , develop a digest of State laws, regulations, and practices pertaining to development, establishment, and operation of health maintenance organizations which shall be updated at least annually and relevant sections of which shall be provided to the Governor of each State annually. Such digest shall indicate which State laws, regulations, and practices appear to be inconsistent with the operation of this section. The Secretary shall also insure that appropriate legal consultative assistance is available to the States for the purpose of complying with the provisions of this section.

July 1, 1944, ch. 373 Pub. L. 93–222, § 287 Stat. 931 Pub. L. 94–460, title I, § 11490 Stat. 1954 Pub. L. 99–660, title VIII, § 809100 Stat. 3801 Pub. L. 100–517, § 8102 Stat. 2583 (, title XIII, § 1311, as added , , ; amended , , ; , , ; , , .)

Editorial Notes

Prior Provisions

section 211a of this titlePub. L. 93–222, § 7(b)A prior section 1311 of act , was classified to prior to repeal by .

Amendments

Pub. L. 100–5171988—Subsec. (a)(1)(E). added subpar. (E).

Pub. L. 99–6601986—Subsec. (c). substituted “annually” for “quarterly” after “at least”.

Pub. L. 94–4601976—Subsec. (c). added subsec. (c).

Statutory Notes and Related Subsidiaries

Effective Date of 1986 Amendment

Pub. L. 99–660section 815(a) of Pub. L. 99–660section 300e–1 of this titleAmendment by effective , see , set out as an Effective and Termination Dates of 1986 Amendment note under .

Effective Date of 1976 Amendment

Pub. L. 94–460section 118 of Pub. L. 94–460section 300e of this titleAmendment by effective , see , set out as a note under .