Nev. Rev. Stat. ch. 695F – Prepaid Limited Health Service Organizations | Midpage

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Nevada Revised Statutes

Chapter 695F

Nev. Rev. Stat. ch. 695F

Prepaid Limited Health Service Organizations

695F.010Definitions 695F.020“Enrollee” defined 695F.030“Evidence of coverage” defined 695F.040“Limited health service” defined 695F.043“Medicaid” defined 695F.047“Order for medical coverage” defined 695F.050“Prepaid limited health service organization” defined 695F.060“Provider” defined 695F.070“Subscriber” defined 695F.080General applicability of title 57 of NRS 695F.090Applicability of chapter and other provisions 695F.100Certificate required 695F.110Application; fee 695F.120Review of application; issuance of certificate 695F.130Application of person who is licensed as insurer or holds another certificate of authority 695F.140Denial of application; hearing 695F.150Evidence of coverage: Issuance; contents; amendment 695F.151Organization 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 695F.153Evidence of coverage covering prescription drugs: Provision of notice and information regarding use of formulary 695F.156Evidence of coverage covering prescription drugs prohibited from limiting or excluding coverage for certain prescription drugs previously approved for medical condition of enrollee; exceptions 695F.157Limitation on cost-sharing obligation of insulin covered under evidence of coverage covering prescription insulin drugs 695F.158Evidence of coverage covering prescription drugs: Required actions by organization related to acquisition of prescription drugs for certain insureds residing in area for which emergency or disaster has been declared 695F.159Evidence of coverage covering prescription drugs: Use of step therapy protocol for drug to treat psychiatric condition prohibited in certain circumstances 695F.160Rates and charges: Reasonableness 695F.170Procedure for modification of rates, charges, benefits, organization, operations, documents or services 695F.190Requirements for reserve 695F.200Maintenance of capital account, surety bond or deposit and risk-based capital; determination of amount of increase by Commissioner 695F.210Maintenance of fidelity bond or deposit in lieu of bond 695F.212Hazardous financial condition: Regulations; determination; powers of Commissioner 695F.220Contract between organization and provider or subcontractor for provision of services to enrollees: Required terms and conditions 695F.225Requirements for notice of denial of claim 695F.230Establishment of system for resolution of complaints 695F.300Regulations 695F.310Examinations and investigations 695F.320Annual report and financial statement; quarterly statement; additional reports; penalties for failure to file report or statement 695F.330Payment of premium tax 695F.340Fees 695F.350Suspension or revocation of certificate of authority: Grounds; notice; hearing; effect 695F.360Violations of chapter: Order to cease and desist; fine 695F.400License required to apply, procure, negotiate or place for another any policy or contract of organization 695F.410Confidentiality and disclosure of information 695F.420Certain insurers and organizations authorized to exclude coverage duplicated pursuant to this chapter 695F.430Provision of services excluded from practice of any healing arts; solicitation excluded from provisions regarding solicitation or advertising by practitioner of healing art 695F.440Effect of eligibility for medical assistance under Medicaid; assignment of rights to state agency 695F.450Organization prohibited from asserting certain grounds to deny enrollment of child pursuant to order if parent is insured 695F.460Certain accommodations required to be made when child is covered under evidence of coverage of noncustodial parent 695F.470Organization 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