--- kind: "section" citation: "42 U.S.C. § 300e–11" title: "42" title_heading: "The Public Health and Welfare" number: "300e–11" heading: "Continued regulation of health maintenance organizations" release: "119-102" date: "2026-07-12" url: "https://uscodex.org/usc/42/300e-11" units: - "Chapter 6A — Public Health Service" - "Subchapter XI — Health Maintenance Organizations" --- # §300e–11. Continued regulation of health maintenance organizations - (a) **Determination of deficiency—** If the [Secretary](/usc/42/201.md?p=c) determines that an entity which received a grant, contract, loan, or loan guarantee under this subchapter as a [health maintenance organization](/usc/42/300gg–91.md?p=b-3) or which was included in a health benefits plan offered to [employees](/usc/42/300gg–91.md?p=d-5) pursuant to [section 300e–9 of this title](/usc/42/300e–9.md)— - (1) fails to provide basic and [supplemental services](/usc/42/300z–1.md?p=a-6) to its [members](/usc/42/300e–1.md?p=3), - (2) fails to provide such [services](/usc/42/201.md?p=a) in the manner prescribed by [section 300e(b) of this title](/usc/42/300e.md?p=b), or - (3) is not organized or operated in the manner prescribed by [section 300e(c) of this title](/usc/42/300e.md?p=c), the [Secretary](/usc/42/201.md?p=c) may take the action authorized by [subsection (b)](#b). - (b) **Action by Secretary upon determination—** - (1) If the [Secretary](/usc/42/201.md?p=c) makes, with respect to any entity which provided assurances to the [Secretary](/usc/42/201.md?p=c) under [section 300e–9(d)(1)](/usc/42/300e–9.md?p=d-1)[^1] of this title, a determination described in [subsection (a)](#a), the [Secretary](/usc/42/201.md?p=c) shall notify the entity in writing of the determination. Such notice shall specify the manner in which the entity has not complied with such assurances and direct that the entity initiate (within 30 days of the date the notice is issued by the [Secretary](/usc/42/201.md?p=c) or within such longer period as the [Secretary](/usc/42/201.md?p=c) determines is reasonable) such action as may be necessary to bring (within such period as the [Secretary](/usc/42/201.md?p=c) shall prescribe) the entity into compliance with the assurances. If the entity fails to initiate corrective action within the period prescribed by the notice or fails to comply with the assurances within such period as the [Secretary](/usc/42/201.md?p=c) prescribes, then after the [Secretary](/usc/42/201.md?p=c) provides the entity a reasonable opportunity for reconsideration of his determination, including, at the entity’s election, a fair hearing (A) the entity shall not be a qualified [health maintenance organization](/usc/42/300gg–91.md?p=b-3) for purposes of [section 300e–9 of this title](/usc/42/300e–9.md) until such date as the [Secretary](/usc/42/201.md?p=c) determines that it is in compliance with the assurances, and (B) each [employer](/usc/42/300gg–91.md?p=d-6) which has offered membership in the entity in compliance with [section 300e–9 of this title](/usc/42/300e–9.md), each lawfully recognized collective bargaining representative or other [employee](/usc/42/300gg–91.md?p=d-5) representative which represents the [employees](/usc/42/300gg–91.md?p=d-5) of each such [employer](/usc/42/300gg–91.md?p=d-6), and the [members](/usc/42/300e–1.md?p=3) of such entity shall be notified by the entity that the entity is not a qualified [health maintenance organization](/usc/42/300gg–91.md?p=b-3) for purposes of such section. The notice required by clause (B) of the preceding sentence shall contain, in readily understandable language, the reasons for the determination that the entity is not a qualified [health maintenance organization](/usc/42/300gg–91.md?p=b-3). The [Secretary](/usc/42/201.md?p=c) shall publish in the Federal Register each determination referred to in this paragraph. - (2) If the [Secretary](/usc/42/201.md?p=c) makes, with respect to an entity which has received a grant, contract, loan, or loan guarantee under this subchapter, a determination described in [subsection (a)](#a), the [Secretary](/usc/42/201.md?p=c) may, in addition to any other remedies available to him, bring a civil action in the United States district court for the district in which such entity is located to enforce its compliance with the assurances it furnished respecting the provision of basic and [supplemental health services](/usc/42/300e–1.md?p=2) or its organization or operation, as the case may be, which assurances were made in connection with its application under this subchapter for the grant, contract, loan, or loan guarantee. ## Footnotes [^1]: See References in Text note below. ## Source credit (July 1, 1944, ch. 373, title XIII, § 1312, as added Pub. L. 93–222, § 2, Dec. 29, 1973, 87 Stat. 931; amended Pub. L. 94–460, title I, § 111, Oct. 8, 1976, 90 Stat. 1952; Pub. L. 95–559, § 12(a)(2), Nov. 1, 1978, 92 Stat. 2140; Pub. L. 97–35, title IX, § 949(a), Aug. 13, 1981, 95 Stat. 578.) ## Notes ### Editorial Notes ### References in Text Section 300e–9(d)(1) of this title, referred to in subsec. (b)(1), was redesignated section 300e–9(c)(1) of this title by Pub. L. 100–517, § 7(b), Oct. 24, 1988, 102 Stat. 2580. ### Prior Provisions A prior section 1312 of act July 1, 1944, was classified to section 212a of this title prior to repeal by Pub. L. 93–222, § 7(b). ### Amendments 1981—Subsec. (b)(1). Pub. L. 97–35 inserted provisions relating to opportunity for reconsideration of determination of Secretary. 1978—Subsec. (c). Pub. L. 95–559 struck out subsec. (c) which provided that the Secretary, acting through the Assistant Secretary for Health, administer subsections (a) and (b) of this section in the Office of the Assistant Secretary for Health. 1976—Subsec. (a). Pub. L. 94–460, § 111(a), substituted “the Secretary may take the action authorized by subsection (b)” for “the Secretary may, in addition to any other remedies available to him, bring a civil action in the United States district court for the district in which such entity is located to enforce its compliance with any assurances it furnished him respecting the provision of basic and supplemental health services or its organization or operation, as the case may be, which assurances were made under section 300e–9 of this title or when application was made under this subchapter for a grant, contract, loan, or loan guarantee”. Subsecs. (b), (c). Pub. L. 94–460, § 111(b), (c), added subsec. (b), redesignated former subsec. (b) as (c), and substituted “acting through the Assistant Secretary for Health, shall administer subsections (a) and (b)” for “through the Assistant Secretary for Health, shall administer subsection (a)”. ### Statutory Notes and Related Subsidiaries ### Effective Date of 1976 Amendment Amendment by Pub. L. 94–460 applicable with respect to determinations of the Secretary of Health, Education, and Welfare described in subsec. (a) of this section and made after Oct. 8, 1976, see section 118 of Pub. L. 94–460, set out as a note under section 300e of this title.