Nev. Rev. Stat. § 687B.970 – Authorization for contracts or policies of insurance for payment of cost of medical or dental care to require prior authorization of care; filing with Commissioner of procedure for obtaining prior authorization; period for health carrier to respond to request for prior authorization; discrimination among persons licensed to provide covered care prohibited

1. Except as otherwise provided in NRS 687B.980, 689A.0405, 689A.0412, 689A.0413, 689A.0418, 689A.0434, 689A.0437, 689A.044, 689A.0445, 689A.0459, 689B.031, 689B.0312, 689B.0313, 689B.0315, 689B.03155, 689B.0317, 689B.0319, 689B.03345, 689B.0374, 689B.0378, 689C.1654, 689C.1665, 689C.1671, 689C.16715, 689C.16745, 689C.1675, 689C.1676, 695A.1843, 695A.18445, 695A.1856, 695A.18565, 695A.1865, 695A.18735, 695A.1874, 695B.1912, 695B.1913, 695B.1914, 695B.19155, 695B.1919, 695B.19197, 695B.19199, 695B.1924, 695B.1925, 695B.1942, 695C.1696, 695C.1699, 695C.1713, 695C.1715, 695C.1735, 695C.17365, 695C.1737, 695C.1743, 695C.1745, 695C.1751, 695G.1643, 695G.170, 695G.1705, 695G.1709, 695G.171, 695G.1714, 695G.17145, 695G.1715, 695G.1719 and 695G.177, any contract or policy of insurance issued by a health carrier which provides for payment of a certain part of medical or dental care may require the insured to obtain prior authorization for that care from the health carrier. The health carrier shall:
1. (a) File its procedure for obtaining prior authorization pursuant to this section for approval by the Commissioner; and
2. (b) Unless a shorter time period is prescribed by a specific statute, including, without limitation, NRS 689A.0446, 689B.0361, 689C.1688, 695A.1859, 695B.19087, 695C.16932 and 695G.1703, and except as otherwise provided by subsection 2, respond to any request for prior authorization by the insured pursuant to this section within:
  1. (1) Two business days after it receives the request; or
  2. (2) If the Prior Authorization and Referrals Operating Rules prescribed by the Committee on Operating Rules for Information Exchange of the Council for Affordable Quality Healthcare, or its successor organization, would allow the health carrier more than 2 business days to respond to a particular request for prior authorization after receiving the request, the time period prescribed by the Rules.
2. Notwithstanding any time period prescribed by the Rules described in subparagraph (2) of paragraph (b) of subsection 1, a health carrier shall respond to a request for prior authorization within 7 calendar days after receiving the request.
3. The Commissioner, in collaboration with the Department of Human Services, shall review each revision to the Rules described in subparagraph (2) of paragraph (b) of subsection 1 to ensure their suitability for this State. If the Commissioner determines that a revision is not suitable for this State, the Commissioner shall give notice within 30 days after the hearing that the revisions are not suitable for this State. If the Commissioner gives such notice, a health carrier shall respond to any request for prior authorization that is submitted to the health carrier after the date on which such notice is given within 2 business days after receiving the request.
4. The procedure for prior authorization may not discriminate among persons licensed to provide the covered care.

(Added to NRS by 1983, 2028; A 1985, 2098; 1997, 307, 1729; 1999, 1943; 2007, 3236; 2021, 2577; 2023, 2111, 2211, 3508; 2025, 1916, 2873, 3037, 3111)—(Substituted in revision for NRS 687B.225)