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Nev. Rev. Stat. ch. 695B – Nonprofit Corporations for Hospital, Medical and Dental Service | Midpage
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Nevada Revised Statutes
Title 57
Chapter 695B
Nev. Rev. Stat. ch. 695B
Nonprofit Corporations for Hospital, Medical and Dental Service
695B.010
Short title
695B.020
Scope
695B.030
Definitions
695B.035
Contract between corporation and provider of health care: Prohibiting corporation from charging provider of health care fee for inclusion on list of providers given to insureds; corporation required to use form to obtain information on provider of health care; modification; submission by corporation of schedule of payments to provider
695B.040
Corporations authorized to undertake and operate plans
695B.050
Manner of incorporation
695B.060
Directors: Qualifications
695B.070
Merger and consolidation: Procedure
695B.080
Merger and consolidation: Continuance of contracts and contribution certificates
695B.090
Merger and consolidation: Withdrawal of prior deposit of securities
695B.110
Certificate of authority: Required; fees
695B.120
Certificate of authority: Qualifications
695B.130
Certificate of authority: Application; issuance
695B.135
Certificate of authority: Expiration; renewal
695B.140
Reserve fund: Minimum amounts; computation; contracts with hospitals; participation of physicians or dentists
695B.150
Insolvency; determination of financial condition; actions by Commissioner; review; regulations
695B.160
Annual statement of condition and affairs; annual financial statement; quarterly statement; fees; examination by Commissioner
695B.165
Annual statement required to include report of net worth
695B.170
Acquisition costs and administrative expenses; effect of finding of excess costs
695B.176
Contract covering prescription drugs: Provision of notice and information regarding use of formulary
695B.180
Required provisions
695B.181
Provision in contract requiring binding arbitration authorized; procedures for arbitration; declaratory relief
695B.182
Required procedure for arbitration of disputes concerning independent medical, dental or chiropractic evaluations
695B.183
Insurer required to offer and issue plan regardless of health status of persons; prohibited acts; authority to include wellness program in plan that offers discounts based on health status under certain circumstances
695B.185
Group contract which offers difference of payment between preferred providers of health care and providers who are not preferred: Limitations on deductibles and copayments; circumstances in which service is deemed to be provided by preferred provider; processing of claims of providers who are not preferred
695B.187
Group contract issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employer
695B.189
Group contract: Required provision permitting continuation of coverage
695B.190
Family contracts
695B.1901
Required provision in certain policies concerning coverage for continued medical treatment; exceptions; regulations
695B.1903
Required provision concerning coverage for certain treatment as part of clinical trial or study for treatment of cancer or chronic fatigue syndrome; authority of corporation to require certain information; immunity from liability
695B.1904
Required provision concerning coverage for services provided through telehealth to same extent as though provided in person or by other means; required provision concerning reimbursement for certain services provided through telehealth in same amount as though provided in person or by other means; prohibited acts
695B.19045
Policy covering prescription drugs: Required actions by corporation related to acquisition of prescription drugs for certain insureds residing in area for which emergency or disaster has been declared
695B.19046
Policy covering prescription drugs: Submission to step therapy protocol for drug to treat psychiatric condition prohibited in certain circumstances
695B.19047
Policy covering prescription drug for medical condition that is part of step therapy protocol: Use of certain guidelines required; establishment of process to request exemption from step therapy protocol required; granting of request; applicability of provisions
695B.1905
Contract covering prescription drugs prohibited from limiting or excluding coverage for certain prescription drugs previously approved for medical condition of insured; exceptions
695B.19055
Limitation on cost-sharing obligation for insulin covered under policy covering prescription insulin drugs prohibited from imposing certain cost-sharing obligations
695B.1906
Required provision in policy covering prescription drugs concerning coverage for prescription drugs irregularly dispensed for purpose of synchronization of chronic medications; prohibited acts; exception
695B.19065
Required provision concerning coverage for screening for lung cancer in policy that provides coverage for treatment of lung cancer
695B.1907
Required provision in policy covering treatment of colorectal cancer concerning coverage for colorectal cancer screening
695B.1908
Required provision in certain contracts concerning coverage for certain drugs and related services for treatment of cancer
695B.19085
Policy covering prescription drug for treatment of cancer or cancer symptom that is part of step therapy protocol: Corporation required to allow insured or attending practitioner to apply exemption from step therapy protocol in certain circumstances; procedure for applying for and granting exemption
695B.19087
Required provision concerning coverage for biomarker testing for diagnosis, treatment, management and monitoring of cancer in certain circumstances; establishment of process to request exception or appeal denial of coverage; time for responding to request for prior authorization
695B.1909
Contract covering treatment of cancer through use of chemotherapy: Prohibited acts related to orally administered chemotherapy
695B.191
Required provision in policy covering mastectomies concerning coverage relating to mastectomy; prohibited acts
695B.1911
Required provision concerning coverage for screening, genetic counseling and testing related to BRCA gene in certain circumstances
695B.1912
Required provision concerning coverage for certain screenings and tests for breast cancer; prohibited acts
695B.1913
Required provision concerning coverage for examination of person who is pregnant for certain diseases
695B.1914
Required provision concerning coverage of certain gynecological and obstetrical services without authorization or referral from primary care physician; designation of obstetrician or gynecologist as primary care provider
695B.1915
Required provision concerning coverage for medically necessary treatment of conditions relating to gender dysphoria and gender incongruence; restriction on refusal to cover certain treatments; authority of corporation to prescribe requirements for covering surgical treatments for minors; determination of medical necessity
695B.19155
Required provision concerning coverage for habilitative speech-language pathology and rehabilitative speech-language pathology as treatment for stuttering for certain persons; prohibited acts
695B.1916
Required provision in contract covering prescription drugs or devices concerning coverage of hormone replacement therapy in certain circumstances; prohibited acts; exception
695B.1918
Required provision in contract covering outpatient care concerning coverage of health care services related to hormone replacement therapy; prohibited acts
695B.1919
Required provision concerning coverage for drug or device for contraception and related health services; prohibited acts; exceptions
695B.19195
Required provision concerning coverage for certain services, screenings and tests relating to wellness; prohibited acts
695B.19197
Required provision concerning coverage for certain drugs and services related to substance use disorder and opioid use disorder; reimbursement of pharmacists and pharmacies for certain services; prohibited acts
695B.19199
Required provision concerning coverage for noninvasive prenatal screening
695B.192
Contract containing exclusion, reduction or limitation of coverage relating to complications of pregnancy prohibited; exception
695B.1923
Required provision concerning coverage for treatment of certain inherited metabolic diseases
695B.1924
Required provision concerning coverage for drugs, laboratory testing and certain services related to human immunodeficiency virus and hepatitis C; reimbursement of certain providers of health care for certain services; prohibited acts
695B.1925
Required provision concerning coverage for certain tests and vaccines relating to human papillomavirus; prohibited acts
695B.1926
Required provision concerning coverage for testing, treatment and prevention of sexually transmitted diseases; required provision concerning coverage for condoms for certain insureds
695B.1927
Required provision in contract covering hospital, medical or surgical expenses concerning coverage for management and treatment of diabetes
695B.1929
Required provision of coverage for management and treatment of sickle cell disease and its variants; policy covering prescription drugs required to provide coverage for medically necessary prescription drugs to treat sickle cell disease and its variants
695B.193
Contract covering family member of subscriber required to include certain coverage for subscriber’s newly born and adopted children and children placed with subscriber for adoption
695B.19305
Required provision concerning coverage for dental service provided by qualified dental hygienist in certain circumstances
695B.1931
Contract prohibited from excluding coverage relating to treatment of temporomandibular joint; exception
695B.1932
Policy covering prescription drugs: Denial of coverage prohibited for early refills of otherwise covered topical ophthalmic products
695B.1942
Required provision in contract covering treatment of prostate cancer concerning coverage for prostate cancer screening; prohibited act
695B.1944
Required provision in certain group contracts concerning continuing coverage for employee or member on leave without pay as result of total disability
695B.1948
Contract covering maternity care: Prohibited acts by insurer if insured is acting as gestational carrier; child deemed child of intended parent for purposes of contract
695B.1949
Contract covering anatomical gifts, organ transplants or treatments or services related to organ transplants: Prohibited acts by insurer if insured is person with disability
695B.1951
Reimbursement for treatment by podiatrist
695B.1955
Reimbursement for treatment by licensed clinical alcohol and drug counselor
695B.196
Reimbursement for acupuncture
695B.197
Reimbursement for treatment by licensed psychologist
695B.1973
Reimbursement for treatment by licensed marriage and family therapist or licensed clinical professional counselor
695B.1975
Reimbursement for treatment by licensed associate in social work, social worker, master social worker, independent social worker or clinical social worker
695B.198
Reimbursement for treatment by chiropractic physician
695B.199
Reimbursement for services provided by certain nurses
695B.1995
Reimbursement to provider of medical transportation
695B.1997
Assignment of benefits by insured to provider of health care
695B.200
Group contracts written under master contract: Conditions required for issuance
695B.210
Group master service contract: Required provisions
695B.220
Blanket service contracts: Issuance to college, school or school personnel; pupils not to be compelled to accept service
695B.225
Policies of group insurance: Order of benefits
695B.230
Filing and approval of forms and schedules of premium rates
695B.240
Provision of group service coverage before approval of forms
695B.250
Extensions of time; automatic approval
695B.2505
Approval or denial of claims; payment of claims and interest; requests for additional information; award of costs and attorney’s fees; compliance with requirements; imposition of administrative fine or suspension or revocation of certificate of authority for failure to comply; report of compliance by corporation
695B.251
Group subscriber contracts required to contain provision for conversion to individual contracts; exceptions
695B.252
Conversion privilege available to spouse and children; conditions
695B.253
Denial of converted contract because of overinsurance; notice concerning cancellation of other coverage
695B.254
Choice of types of contracts required to be offered
695B.255
Benefits exceeding those provided under group contract not required; exclusions and limitations
695B.2555
Benefits payable under converted contract authorized to be reduced by amount payable under group contract; limitation
695B.256
Issuance and effective date of converted contract; premiums; persons covered
695B.2565
Renewal of converted contract: Request for information on sources of other benefits; grounds for refusal to renew; notice concerning cancellation of other coverage
695B.257
Notice of conversion privilege
695B.2575
Converted contract delivered outside Nevada: Form
695B.258
Extension of coverage under existing group contract
695B.2585
Provision of group coverage in lieu of converted individual contract
695B.259
Continuation of identical coverage in lieu of converted contract
695B.260
Suspension or revocation of permission to provide coverage before approval of forms
695B.270
Disapproval of forms; issuance unlawful
695B.280
Regulations; limitations
695B.285
Use of Uniform Billing and Claims Forms authorized
695B.290
Agent’s license required
695B.300
Contracts with agencies or political subdivisions of United States or State of Nevada; acceptance of money; subcontracts
695B.310
Corporation subject to same taxes, licenses, fees and supervision as domestic mutual insurer
695B.315
Provision of information regarding claims by policyholder for renewal of insurance policy required upon request; fee; regulations
695B.316
Corporation prohibited from denying coverage solely because claim involves act that constitutes domestic violence or applicant or insured was victim of domestic violence
695B.3165
Corporation prohibited from denying coverage solely because applicant or insured was intoxicated or under the influence of controlled substance; exceptions
695B.3167
Corporation prohibited from discriminating against person with respect to participation or coverage on basis of gender identity or expression
695B.317
Corporation that provides health insurance prohibited from requiring or using information concerning genetic testing; exceptions
695B.318
Applicability of certain provisions concerning portability and availability of health insurance
695B.319
Offering policy of health insurance for purposes of establishing health savings account
695B.320
Applicability of other provisions
695B.330
Definitions
695B.340
Effect of eligibility for medical assistance under Medicaid; assignment of rights to state agency
695B.350
Corporation prohibited from asserting certain grounds to deny enrollment of child of insured pursuant to order
695B.360
Certain accommodations required to be made when child is covered under policy of noncustodial parent
695B.370
Corporation required to authorize enrollment of child of parent who is required by order to provide medical coverage under certain circumstances; termination of coverage of child
695B.380
Establishment; approval; requirements; examination
695B.390
Annual report; insurer required to maintain records of complaints concerning something other than health care services
695B.400
Written notice to insured required to be provided by insurer explaining right to file complaint; written notice to insured required when insurer denies coverage of health care service