{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-5809.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-5809.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-5809.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-5809.html"}],"law_id":75727,"edition_id":1,"section_id":75727,"structure_id":13783,"section_number":"38.2-5809","catch_line":"Suspension or revocation of license","history":"1998, c. 891.","full_text":"The Commission may suspend or revoke any license issued to a health carrier if it finds that any of the following conditions exist:\n\n1\n\nThe State Health Commissioner certifies to the Commission pursuant to § 32.1-137.5 that the health carrier or its MCHIP is unable to fulfill its obligations to furnish quality health care services as set forth in Article 1.1 (§ 32.1-137.1 et seq.) of Chapter 5 of Title 32.1. The suspension of a certificate of quality assurance shall not be deemed such a certification by the State Health Commissioner.2\n\nThe State Health Commissioner notifies the Commission that the health carrier has failed to implement the complaint system required by Title 32.1 and § 38.2-5804 to resolve valid complaints reasonably.3\n\nThe Commission determines that a certificate of quality assurance issued to the health carrier has been revoked by the State Health Commissioner, or a request for renewal of such certificate has been denied or disapproved by the State Health Commissioner.","order_by":null,"text":{"0":{"id":271924,"text":"The Commission may suspend or revoke any license issued to a health carrier if it finds that any of the following conditions exist:","type":"section","prefixes":[""],"prefix":"","entire_prefix":"","prefix_anchor":"","level":1,"next_prefix":"1"},"1":{"id":271925,"text":"The State Health Commissioner certifies to the Commission pursuant to § 32.1-137.5 that the health carrier or its MCHIP is unable to fulfill its obligations to furnish quality health care services as set forth in Article 1.1 (§ 32.1-137.1 et seq.) of Chapter 5 of Title 32.1. The suspension of a certificate of quality assurance shall not be deemed such a certification by the State Health Commissioner.","type":"section","prefixes":["1"],"prefix":"1","entire_prefix":"1","prefix_anchor":"1","level":1,"prior_prefix":"","next_prefix":"2"},"2":{"id":271926,"text":"The State Health Commissioner notifies the Commission that the health carrier has failed to implement the complaint system required by Title 32.1 and § 38.2-5804 to resolve valid complaints reasonably.","type":"section","prefixes":["2"],"prefix":"2","entire_prefix":"2","prefix_anchor":"2","level":1,"prior_prefix":"1","next_prefix":"3"},"3":{"id":271927,"text":"The Commission determines that a certificate of quality assurance issued to the health carrier has been revoked by the State Health Commissioner, or a request for renewal of such certificate has been denied or disapproved by the State Health Commissioner.","type":"section","prefixes":["3"],"prefix":"3","entire_prefix":"3","prefix_anchor":"3","level":1,"prior_prefix":"2"}},"ancestry":[{"id":13783,"edition_id":1,"name":"Managed Care Health Insurance Plans","identifier":"58","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:45:52","date_modified":"2026-06-26 03:45:52","permalink":{"id":217945,"object_type":"structure","relational_id":13783,"identifier":"58","token":"38.2\/58","url":"\/38.2\/58\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12698,"edition_id":1,"name":"Insurance","identifier":"38.2","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:49","date_modified":"2026-06-26 03:43:49","permalink":{"id":210661,"object_type":"structure","relational_id":12698,"identifier":"38.2","token":"38.2","url":"\/38.2\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":77304,"structure_id":13783,"section_number":"38.2-5800","catch_line":"Definitions","url":"\/38.2-5800\/","token":"38.2\/58\/38.2-5800","metadata":false},{"id":64894,"structure_id":13783,"section_number":"38.2-5801","catch_line":"General provisions","url":"\/38.2-5801\/","token":"38.2\/58\/38.2-5801","metadata":false},{"id":54793,"structure_id":13783,"section_number":"38.2-5802","catch_line":"Establishment of an MCHIP","url":"\/38.2-5802\/","token":"38.2\/58\/38.2-5802","metadata":false},{"id":62075,"structure_id":13783,"section_number":"38.2-5803","catch_line":"Disclosures and representations to enrollees","url":"\/38.2-5803\/","token":"38.2\/58\/38.2-5803","metadata":false},{"id":74962,"structure_id":13783,"section_number":"38.2-5804","catch_line":"Complaint system","url":"\/38.2-5804\/","token":"38.2\/58\/38.2-5804","metadata":false},{"id":81176,"structure_id":13783,"section_number":"38.2-5805","catch_line":"Provider contracts","url":"\/38.2-5805\/","token":"38.2\/58\/38.2-5805","metadata":false},{"id":71053,"structure_id":13783,"section_number":"38.2-5806","catch_line":"Prohibited practices","url":"\/38.2-5806\/","token":"38.2\/58\/38.2-5806","metadata":false},{"id":63869,"structure_id":13783,"section_number":"38.2-5807","catch_line":"Access to care","url":"\/38.2-5807\/","token":"38.2\/58\/38.2-5807","metadata":false},{"id":60038,"structure_id":13783,"section_number":"38.2-5808","catch_line":"Examinations","url":"\/38.2-5808\/","token":"38.2\/58\/38.2-5808","metadata":false},{"id":75727,"structure_id":13783,"section_number":"38.2-5809","catch_line":"Suspension or revocation of license","url":"\/38.2-5809\/","token":"38.2\/58\/38.2-5809","metadata":false},{"id":70898,"structure_id":13783,"section_number":"38.2-5810","catch_line":"Statutory construction and relationship to other laws","url":"\/38.2-5810\/","token":"38.2\/58\/38.2-5810","metadata":false},{"id":68954,"structure_id":13783,"section_number":"38.2-5811","catch_line":"Controversies involving contracts","url":"\/38.2-5811\/","token":"38.2\/58\/38.2-5811","metadata":false}],"previous_section":{"id":60038,"structure_id":13783,"section_number":"38.2-5808","catch_line":"Examinations","url":"\/38.2-5808\/","token":"38.2\/58\/38.2-5808","metadata":false},"next_section":{"id":70898,"structure_id":13783,"section_number":"38.2-5810","catch_line":"Statutory construction and relationship to other laws","url":"\/38.2-5810\/","token":"38.2\/58\/38.2-5810","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-5809\/","history_text":"

This law was first created in 1998. The record of its establishment is cataloged in chapter 891<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year.<\/p>","references":false,"refers_to":[{"id":61229,"section_number":"32.1-137.1","catch_line":"Definitions","order_by":null,"url":"\/32.1-137.1\/"},{"id":61098,"section_number":"32.1-137.5","catch_line":"Civil penalties; probation; suspension; restriction or prohibition of new enrollments to managed care health insurance plan licensee; revocation or nonrenewal of certificate of quality assurance; appeal process; correction","order_by":null,"url":"\/32.1-137.5\/"},{"id":74962,"section_number":"38.2-5804","catch_line":"Complaint system","order_by":null,"url":"\/38.2-5804\/"}],"permalink":{"id":217983,"object_type":"law","relational_id":75727,"identifier":"38.2-5809","token":"38.2\/58\/38.2-5809","url":"\/38.2-5809\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-5809\/","token":"38.2\/58\/38.2-5809","dublin_core":{"Title":"Suspension or revocation of license","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-5809","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

The Commission<\/span> may suspend or revoke any license issued to a health carrier<\/span> if it finds that any of the following conditions exist:<\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> The State<\/span> Health Commissioner<\/span> certifies to the Commission<\/span> pursuant to § 32.1-137.5<\/a> that the health carrier<\/span> or its MCHIP<\/span> is unable to fulfill its obligations to furnish quality health care services<\/span> as set forth in Article 1.1 (§ 32.1-137.1<\/a> et seq.) of Chapter 5 of Title 32.1. The suspension of a certificate of quality assurance shall not be deemed such a certification by the State<\/span> Health Commissioner<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> The State<\/span> Health Commissioner<\/span> notifies the Commission<\/span> that the health carrier<\/span> has failed to implement the complaint system required by Title 32.1 and § 38.2-5804<\/a> to resolve valid complaints reasonably. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> The Commission<\/span> determines that a certificate of quality assurance issued to the health carrier<\/span> has been revoked by the State<\/span> Health Commissioner<\/span>, or a request for renewal of such certificate has been denied or disapproved by the State<\/span> Health Commissioner<\/span>. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nSUSPENSION OR REVOCATION OF LICENSE (\u00a7 38.2-5809)\n\nThe Commission may suspend or revoke any license issued to a health carrier if\nit finds that any of the following conditions exist:\n\n1. The State Health Commissioner certifies to the Commission pursuant to §\n32.1-137.5 that the health carrier or its MCHIP is unable to fulfill its\nobligations to furnish quality health care services as set forth in Article 1.1\n(§ 32.1-137.1 et seq.) of Chapter 5 of Title 32.1. The suspension of a\ncertificate of quality assurance shall not be deemed such a certification by the\nState Health Commissioner.\n\n2. The State Health Commissioner notifies the Commission that the health carrier\nhas failed to implement the complaint system required by Title 32.1 and §\n38.2-5804 to resolve valid complaints reasonably.\n\n3. The Commission determines that a certificate of quality assurance issued to\nthe health carrier has been revoked by the State Health Commissioner, or a\nrequest for renewal of such certificate has been denied or disapproved by the\nState Health Commissioner.\n\nHISTORY: 1998, c. 891.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}