- 1. If an injured employee has filed a claim pursuant to NRS 617.455 or 617.457 and, at the time the claim is filed, the panel of physicians or chiropractic physicians maintained by the Administrator pursuant to NRS 616C.090 contains fewer than 12 physicians or chiropractic physicians in a discipline or specialization appropriate for the treatment of or the provision of other services relating to the occupational disease of the injured employee who are accepting new patients and are available to meet with the injured employee within 30 days after the date on which the injured employee first contacts the physician or chiropractic physician to request an appointment, the injured employee may seek treatment or other services related to the occupational disease of the injured employee from a physician or chiropractic physician of his or her choice selected in accordance with subsection 2.
- 2. An injured employee may select a physician or chiropractic physician of his or her choice pursuant to subsection 1 from a list of all physicians or chiropractic physicians in the relevant discipline or specialization who have entered into a contract with an organization for managed care, under a health benefit plan or otherwise with a health insurer or casualty insurer of the employer of the injured employee, whether or not the physician or chiropractic physician has specifically contracted to provide treatment or other services to employees for injuries and diseases that are compensable pursuant to chapters 616A to 617, inclusive, of NRS, or has been previously approved pursuant to NRS 616B.527.
- 3. If an injured employee seeks treatment or services pursuant to subsection 1, the treatment or services may be paid for by the injured employee or a health insurer or casualty insurer on behalf of the injured employee.
4. Full reimbursement of the amount paid by:
- (a) The injured employee who paid for his or her own treatment or services; or
(b) A health insurer or casualty insurer who paid for treatment or services on behalf of the injured employee,
pursuant to subsection 3 may be sought by the injured employee, health insurer or casualty insurer, as applicable, from the employer of the injured employee or an insurer, organization for managed care or third-party administrator, as applicable, who is obligated to provide applicable coverage or benefits to the injured employee.
5. To seek reimbursement as described in subsection 4, the injured employee, health insurer or casualty insurer must submit a request for reimbursement to the employer of the injured employee or the employer’s insurer, organization for managed care or third-party administrator, as applicable. The request for reimbursement must include, without limitation:
- (a) The identity of the injured employee for whom the costs of treatment and services was paid.
- (b) A description of the treatment and services provided to the injured employee.
- (c) The identity of the person who paid for the treatment and services for the injured employee.
- (d) The costs of treatment and services for which reimbursement is being requested.
- 6. Not later than 30 days after receipt of a request for reimbursement submitted pursuant to subsection 5, the employer of the injured employee or the employer’s insurer, organization for managed care or third-party administrator, as applicable, from whom reimbursement is sought shall fully reimburse the injured employee, health insurer or casualty insurer, as applicable, who paid for treatment and services on behalf of the injured employee for the amount paid for the treatment or services as set forth in the request for reimbursement.
- 7. If the Administrator determines that an insurer, organization for managed care or third-party administrator has failed to fully reimburse an injured employee, health insurer or casualty insurer, as applicable, within the time required by subsection 6, the Administrator shall order the insurer, organization for managed care or third-party administrator to pay to the injured employee, health insurer or casualty insurer, as applicable, an amount equal to two times the amount of reimbursement that remains unpaid on the date on which the Administrator issues the order.
8. Any amount ordered by the Administrator to be paid pursuant to subsection 7 is in addition to any amounts for:
- (a) Benefits to which the injured employee is entitled under the claim for the occupational disease set forth in NRS 617.455 or 617.457, as applicable; and
- (b) Any fines and penalties imposed by the Administrator pursuant to NRS 616D.120.
9. As used in this section:
- (a) “Casualty insurer” means an insurer or other organization providing coverage or benefits under a policy or contract of casualty insurance in the manner described in subsection 2 of NRS 681A.020.
- (b) “Health benefit plan” means any type of policy, contract, agreement or plan providing health coverage or benefits in accordance with state or federal law.
- (c) “Health insurer” means an insurer or other organization providing health coverage or benefits in accordance with state or federal law.
(Added to NRS by 2025, 2948)