Nev. Rev. Stat. ch. 439B – Restraining Costs of Health Care | Midpage

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Nevada Revised Statutes

Chapter 439B

Nev. Rev. Stat. ch. 439B

Restraining Costs of Health Care

439B.010Definitions 439B.015“Authority” defined 439B.030“Billed charge” defined 439B.035“Children’s Health Insurance Program” defined 439B.040“Committee” defined 439B.050“Department” defined 439B.060“Director” defined 439B.070“Discharge form” defined 439B.090“Fiscal year” defined 439B.100“Health facility” defined 439B.110“Hospital” defined 439B.115“Major hospital” defined 439B.120“Medicaid” defined 439B.130“Medicare” defined 439B.140“Net revenue” defined 439B.150“Practitioner” defined 439B.160Purposes of chapter 439B.220Powers 439B.225Committee to review certain regulations proposed or adopted by licensing boards; recommendations to Legislature 439B.227Committee to review certain new provisions of law; recommendations to Legislature concerning mandated reporters 439B.260Reduction of billed charges for certain patients and services; notice; resolution of disputes 439B.265Collection of deductible or copayment from indigent patient covered by Medicare prohibited 439B.270Foundation for hospital nursing practice: Establishment; governing body 439B.275Program for provision of technical assistance to rural hospitals 439B.280Educational program to promote wellness, physical fitness and prevention of disease, accidents and motor vehicle crashes 439B.2801Definitions 439B.2803“Diagnosis-related group” defined 439B.2805“Healing art” defined 439B.2807“Health benefit plan” defined 439B.2809“Health care entity” defined 439B.2811“Medical debt” defined 439B.2813“Medical debtor” defined 439B.2815“National Drug Code” defined 439B.2817“Practitioner group practice” defined 439B.2819“Small practitioner group practice” defined 439B.2821“Third party” defined 439B.2823Publication by hospital of list of items and services with standard charge; exempt information 439B.2825Publication by hospital of lists of shoppable services; exempt information and hospitals 439B.2827Manner of publication of lists 439B.2829Submission by hospital of report relating to facility fees; publication of report 439B.2831Noncompliant hospital prohibited from taking certain actions relating to medical debt; investigation of violations; cancellation and refund of certain medical debt 439B.2833Complaints regarding noncompliance; monitoring of compliance; regulations 439B.2835Notice of violation; plan of correction 439B.2837Administrative penalty 439B.2839Internet website to inform public concerning violations; confidentiality of certain documents and information; certain documents deemed public records 439B.2841Information to be provided by health care entity before collection of medical debt; itemized receipt upon payment of medical debt; investigation of violations; deceptive trade practice; exemption 439B.300Legislative findings and declarations; applicability 439B.310“Indigent” defined 439B.320Hospital required to provide care for proportionate share of indigent patients; duties of Department and board of county commissioners; reimbursement for care 439B.330Eligibility of indigent for assistance; payment of hospital for serving disproportionately large share of patients; discharge forms; appeal from determination of county regarding indigent status 439B.340Report on indigent patients treated; verification by Director; compensation for treatment provided in excess of obligation; assessment for failure to fulfill minimum obligation 439B.350Department to establish; purpose 439B.360Evaluation: Recommendations; report to Interim Finance Committee 439B.370Director authorized to contract for certain services 439B.400Hospital must maintain and use uniform list of billed charges; exception 439B.410Hospital required to provide emergency services and care; unlawful acts of hospital or physician working in hospital emergency room; treating hospital may recover penalty from transferring hospital; exceptions; administrative investigations and sanctions 439B.420Prohibited acts of hospitals and related entities; exceptions; submission of contracts to Director; civil penalty 439B.425Prohibited referral of patients; exceptions; penalty 439B.430Prohibited acts of hospitals; examination by Director; administrative fine; injunctive relief 439B.440Director may require hospitals, health facilities and providers of health services to submit information; independent audit; examinations; penalty 439B.450Powers and duties of Director 439B.460Director authorized to delegate powers and duties 439B.500Penalty for violation of provisions 439B.600Definitions 439B.605“Manufacturer” defined 439B.607“National Drug Code” defined 439B.610“Pharmacy” defined 439B.615“Pharmacy benefit manager” defined 439B.616“Rebate” defined 439B.618“Third party” defined 439B.619“Unit” defined 439B.620“Wholesale acquisition cost” defined 439B.622“Wholesaler” defined 439B.625Organization representing interests of retail merchants to prepare and update list of most commonly prescribed drugs or generic equivalents 439B.630Authority to annually compile lists of certain prescription drugs 439B.635Manufacturer of certain prescription drugs to prepare, submit and affirm accuracy of annual report; contents of report 439B.640Manufacturer of drug that has undergone significant price increase to submit report describing reasons for increase; affirmation of accuracy of report; contents of report 439B.642Wholesaler of certain prescription drugs to prepare, submit and affirm accuracy of annual report; contents of report 439B.645Pharmacy benefit manager to submit and affirm accuracy of annual report concerning certain drugs; contents of report 439B.650Authority to compile annual report concerning price of certain drugs; contents of report; presentation of report at public hearing 439B.655Pharmacies to provide to Authority contact information, electronic mail address and address of Internet website; exceptions 439B.660Manufacturer required to provide list of its pharmaceutical sales representatives; electronic access to list; prohibition against unlisted person marketing prescription drugs; reports 439B.665Report by certain nonprofit organizations that receive items of value from manufacturer 439B.670Authority to place on Internet website certain information concerning pharmacies, nonprofit organizations and prescription drugs and certain reports by Authority; additional or alternative procedures for obtaining information concerning pharmacies, nonprofit organizations and prescription drugs 439B.675Manner of presentation of information 439B.680Immunity from civil and criminal liability 439B.685Regulations 439B.690Suspension of components of program or duties of Authority if sufficient money not available; acceptance of gifts and grants 439B.695Administrative penalty for failure to provide information to Authority; use of money collected by Authority 439B.700Definitions 439B.703“Covered person” defined 439B.706“Independent center for emergency medical care” defined 439B.709“In-network emergency facility” defined 439B.712“In-network provider” defined 439B.715“Medically necessary emergency services” defined 439B.718“Out-of-network emergency facility” defined 439B.721“Out-of-network provider” defined 439B.724“Provider contract” defined 439B.727“Provider of health care” defined 439B.730“Prudent person” defined 439B.733“Screen” defined 439B.736“Third party” defined 439B.739“To stabilize” and “stabilized” defined 439B.742Inapplicability of provisions to certain hospitals, persons and health care services 439B.745Limitation on amount out-of-network provider may collect from covered person; duties of out-of-network emergency facility upon providing services 439B.748Payment to out-of-network emergency facility by third party 439B.751Payment to out-of-network provider, other than emergency facility, by third party 439B.754Determination of amount owed when no recent contract exists between out-of-network provider and third party; arbitration to resolve dispute; no interest pending resolution of dispute; confidentiality of arbitration 439B.757Election by certain entities and organizations not otherwise covered to submit to provisions; regulations 439B.760Reports; confidentiality of information 439B.800Definitions 439B.805“All-payer claims database” defined 439B.810“Covered entity” defined 439B.815“Direct patient identifier” defined 439B.817“Office” defined 439B.820“Proprietary financial information” defined 439B.825“Provider of health care” defined 439B.830“Unique identifier” defined 439B.835Establishment of database; duties of Office; advisory committees 439B.840Entities required and authorized to submit data to database; removal of direct patient identifiers and assignment of unique identifiers 439B.845Confidentiality of data; compliance with certain federal law; use of data in enforcement proceedings 439B.850Data requests 439B.855Access to and use of data; prohibition on release of data to certain entities; duties of recipient of data; requirement to include certain information in report which contains or uses data 439B.860Report concerning quality, efficiency and cost of health care based on data; publication of list of reports Office intends to publish in next calendar year 439B.865Reports concerning cost, performance and effectiveness of database and information concerning grants 439B.870Immunity from certain civil or criminal liability 439B.875Regulations; administrative penalties; contracts and agreements; gifts, grants and donations; accounting and use of administrative penalties by Office