Section 34: Functions of Health Maintenance Organisation: and Mutual Health Associations.

(1) A Health Maintenance Organisation shall -
(a) have roles as may be assigned to it by a State health insurance schemes including the role of Third Party Administrator;
(b) where employed to collect contributions, ensure prompt remittance of contributions to State pools;
(c) perform other administrative actions as required under this Act;
(d) pay administrative charges to the Authority for purposes of regulation and related issues.
(e) pay for services rendered by health care providers accredited under the Authority, for private health insurance.
(f) establish a quality assurance system to ensure that qualitative care is given by the health care providers to enrollees;
(g) render to the Authority returns on its activities as may be required by the Council; and
(h) perform any other function as may be determined by the Authority.
(2) Any private health insurance plans marketed by a Health Maintenance Organisation shall be subject to approval by the Authority.
(3) Notwithstanding the provisions of this Act, a Health Maintenance Organisation shall not be involved in the direct delivery of health care services.
(4) A Mutual Health Associations shall-
(a) have continuous community mobilisation and sensitisation;
(b) negotiate with providers and purchase services for its members and their families in consultation with the Authority;
(c) ensure prompt remittance of contributions collected on behalf of the members to the State health insurance scheme;
(d) assist in ensuring quality assurance; and
(e) perform any other function as may be determined by the Authority.