Title 57

NRS 695C.265 Required procedure for arbitration of disputes concerning independent medical, dental or chiropractic evaluations. 1. If a health maintenance organization, for any final determination of benefits or care, requires an independent evaluation of the medical, dental or c…

NRS 695C.267 Provision requiring binding arbitration authorized; procedures for arbitration; declaratory relief. 1. Except as otherwise provided in NRS 695C.265 and subject to the approval of the Commissioner, a health maintenance organization may include in any evidence of cover…

NRS 695C.270 Surety bond or deposit required; waiver. Each health maintenance organization shall furnish a surety bond in an amount satisfactory to the Commissioner or deposit with the Commissioner cash or securities acceptable to the Commissioner in at least the same amount as a…

NRS 695C.275 Commissioner required to adopt regulations for licensing of provider-sponsored organizations to extent authorized by federal law. 1. To the extent authorized by federal law, the Commissioner shall adopt regulations for the licensing of provider-sponsored organization…

NRS 695C.280 Commissioner authorized to adopt regulations for licensing of agents or brokers. The Commissioner may adopt such reasonable regulations as are necessary to provide for the licensing of agents or brokers. An agent is a person directly or indirectly associated with a h…

NRS 695C.290 Insurance company authorized to establish or contract with health maintenance organization. 1. An insurance company licensed in this State may either directly or through a subsidiary or affiliate organize and operate a health maintenance organization under the provis…

NRS 695C.300 Prohibited practices. 1. No health maintenance organization or representative thereof may cause or knowingly permit the use of advertising which is untrue or misleading, solicitation which is untrue or misleading or any form of evidence of coverage which is deceptive…

NRS 695C.310 Examinations by Commissioner: Affairs of and compliance program used by health maintenance organization; submission of books and records; assessment of expenses; exception. 1. The Commissioner shall make an examination of the affairs of any health maintenance organiz…

NRS 695C.311 Examinations by Commissioner: Financial condition of health maintenance organization; application for initial certificate of authority; exception. 1. For the purpose of determining its financial condition, fulfillment of its contractual obligations and compliance wit…

NRS 695C.313 Financial examination: Procedure; appointment of examiner; maintenance and use of records; penalty for obstruction or interference. 1. If the Commissioner determines to examine a health maintenance organization pursuant to NRS 695C.311, the Commissioner shall designa…

NRS 695C.315 Financial examination: Payment of expense. 1. The health maintenance organization being examined shall pay the expense of an examination. The expenses to be paid include only the reasonable and proper travel and lodging expenses of the Commissioner and the examiners …

NRS 695C.317 Procedures required for examination and hearing. The Commissioner shall use the procedures required by: 1. NRS 679B.230 to 679B.290, inclusive, when conducting an examination of a health maintenance organization. 2. NRS 679B.310 to 679B.370, inclusive, when conductin…

NRS 695C.318 Insolvency; determination of financial condition; actions by Commissioner; review; regulations. 1. A health maintenance organization shall be deemed to be insolvent if: (a) The health maintenance organization fails to meet its obligations as they mature; and (b) The …

NRS 695C.319 Power of Commissioner to order corrective action for hazardous operation or violation of law; regulations. 1. If the Commissioner determines that, because of the financial condition of a health maintenance organization, the continued operation of the health maintenan…

NRS 695C.3195 Conservation, rehabilitation or liquidation of health maintenance organization: Powers of Commissioner; claims of enrollees; distribution of general assets. 1. Any conservation, rehabilitation or liquidation of a health maintenance organization shall be deemed to be…

NRS 695C.320 Rehabilitation, liquidation or conservation: Conduct. Any rehabilitation, liquidation or conservation of a health maintenance organization shall be deemed to be the rehabilitation, liquidation or conservation of an insurance company and shall be conducted under the s…

NRS 695C.325 Offering health care plan to certain small employers for purposes of establishing medical savings accounts. A health maintenance organization may offer to a small employer who has not less than 2 and not more than 50 employees, a health care plan that has a high dedu…

NRS 695C.326 Health maintenance organization required to provide data relating to claims and costs to person responsible for overseeing health care plan upon request; annual report; format. 1. Notwithstanding any other provision of law that provides for the confidentiality of the…

NRS 695C.328 Disclosure of data relating to claims and costs prohibited; exceptions; penalties for unauthorized disclosure. 1. Except as otherwise provided in subsection 2: (a) A person responsible for overseeing a health care plan for a group purchaser shall not disclose data ma…

NRS 695C.329 Penalty for failure of health maintenance organization to comply with certain requirements for electronic maintenance, transmittal and exchange of health information. 1. If the Commissioner receives notification from the Nevada Health Authority pursuant to NRS 439.58…

NRS 695C.330 Disciplinary proceedings: Grounds; effect of suspension or revocation. 1. The Commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization pursuant to the provisions of this chapter if the Commissioner finds that any of …

NRS 695C.340 Disciplinary proceedings: Notice; hearing; judicial review. 1. When the Commissioner has cause to believe that grounds for the denial of an application for a certificate of authority exist, or that grounds for the suspension or revocation of a certificate of authorit…

NRS 695C.350 Violations: Remedies; penalties. 1. The Commissioner may, in lieu of suspension or revocation of a certificate of authority under NRS 695C.330, levy an administrative penalty in an amount not more than $2,500 for each act or violation, if reasonable notice in writing…