Nevada Revised Statutes 695C.187 – Schedule for payment of claims: Mandatory inclusion in arrangements for provision of health care
1. A health maintenance organization shall not:
Terms Used In Nevada Revised Statutes 695C.187
- Contract: A legal written agreement that becomes binding when signed.
- Health maintenance organization: means any person which provides or arranges for provision of a health care service or services and is responsible for the availability and accessibility of such service or services to its enrollees, which services are paid for or on behalf of the enrollees on a periodic prepaid basis without regard to the dates health services are rendered and without regard to the extent of services actually furnished to the enrollees, except that supplementing the fixed prepayments by nominal additional payments for services in accordance with regulations adopted by the Commissioner shall not be deemed to render the arrangement not to be on a prepaid basis. See Nevada Revised Statutes 695C.030
- Provider: means any physician, hospital or other person who is licensed or otherwise authorized in this state to furnish health care services. See Nevada Revised Statutes 695C.030
(a) Enter into any contract or agreement, or make any other arrangements, with a provider for the provision of health care; or
(b) Employ a provider pursuant to a contract, an agreement or any other arrangement to provide health care, unless the contract, agreement or other arrangement specifically provides that the health maintenance organization and provider agree to the schedule for the payment of claims set forth in NRS 695C.185.
2. Any contract, agreement or other arrangement between a health maintenance organization and a provider that is entered into or renewed on or after October 1, 2001, that does not specifically include a provision concerning the schedule for the payment of claims as required by subsection 1 shall be deemed to conform with the requirements of subsection 1 by operation of law.