§ 695C.185 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 au
§ 695C.187 Schedule for payment of claims: Mandatory inclusion in arrangements for provision of health care
§ 695C.190 Commissioner authorized to require submission of information necessary to determine approval or disapproval of filing
§ 695C.194 Provision of health care services to recipients of Medicaid or enrollees in Children’s Health Insurance Program: Requirement to contract with hospital with certain endorsement for inclusion in network of providers
§ 695C.200 Approval of forms and schedules
§ 695C.201 Offering policy of health insurance for purposes of establishing health savings account
§ 695C.202 Provision of health care services to recipients of Medicaid: Notice to recipients if Department of Health and Human Services obtains waiver to provide dental care to persons with diabetes; coordination to ensure receipt of such care
§ 695C.203 Health maintenance organization prohibited from denying coverage solely because claim involves act that constitutes domestic violence or applicant or insured was victim of domestic violence
§ 695C.205 Health maintenance organization prohibited from denying coverage solely because applicant or insured was intoxicated or under the influence of controlled substance; exceptions
§ 695C.207 Health maintenance organization prohibited from requiring or using information concerning genetic testing
§ 695C.210 Annual report of financial condition and financial statement; quarterly statement; administrative penalty for failure to file timely report or statement; extension of time
§ 695C.215 Financial statement required to include report of net worth
§ 695C.220 Applications, filings and reports open to public inspection; exception
§ 695C.230 Fees; forwarding of premium tax
§ 695C.240 Information required to be available for inspection
§ 695C.260 Establishment of system for resolving complaints and system for conducting external review of adverse determinations required
§ 695C.265 Required procedure for arbitration of disputes concerning independent medical, dental or chiropractic evaluations
§ 695C.267 Provision requiring binding arbitration authorized; procedures for arbitration; declaratory relief
§ 695C.270 Surety bond or deposit required; waiver
§ 695C.275 Commissioner required to adopt regulations for licensing of provider-sponsored organizations to extent authorized by federal law
§ 695C.280 Commissioner authorized to adopt regulations for licensing of agents or brokers
§ 695C.290 Insurance company authorized to establish or contract with health maintenance organization
§ 695C.300 Prohibited practices
§ 695C.310 Examinations by Commissioner: Affairs of and compliance program used by health maintenance organization; submission of books and records; assessment of expenses; exception
§ 695C.311 Examinations by Commissioner: Financial condition of health maintenance organization; application for initial certificate of authority; exception
§ 695C.313 Financial examination: Procedure; appointment of examiner; maintenance and use of records; penalty for obstruction or interference
§ 695C.315 Financial examination: Payment of expense
§ 695C.317 Procedures required for examination and hearing
§ 695C.3175 Required contract with insurance company for provision of insurance, indemnity or reimbursement against cost of health care services; required provisions. [Repealed.]
§ 695C.318 Insolvency; determination of financial condition; actions by Commissioner; review; regulations
§ 695C.3185 Plan for continuation of benefits if health maintenance organization becomes insolvent or impaired; approval by Commissioner; contents. [Repealed.]
§ 695C.319 Power of Commissioner to order corrective action for hazardous operation or violation of law; regulations
§ 695C.3195 Conservation, rehabilitation or liquidation of health maintenance organization: Powers of Commissioner; claims of enrollees; distribution of general assets
§ 695C.320 Rehabilitation, liquidation or conservation: Conduct
§ 695C.325 Offering health care plan to certain small employers for purposes of establishing medical savings accounts
§ 695C.326 Health maintenance organization required to provide data relating to claims and costs to person responsible for overseeing health care plan upon request; annual report; format
§ 695C.328 Disclosure of data relating to claims and costs prohibited; exceptions; penalties for unauthorized disclosure
§ 695C.330 Disciplinary proceedings: Grounds; effect of suspension or revocation
§ 695C.340 Disciplinary proceedings: Notice; hearing; judicial review
§ 695C.350 Violations: Remedies; penalties

Terms Used In Nevada Revised Statutes > Chapter 695C > Miscellaneous Provisions

  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Comprehensive health care services: means medical services, dentistry, drugs, psychiatric and optometric and all other care necessary for the delivery of services to the consumer. See Nevada Revised Statutes 695C.030
  • controlled substance: means a drug, immediate precursor or other substance which is listed in schedule I, II, III, IV or V for control by the State Board of Pharmacy pursuant to NRS 453. See Nevada Revised Statutes 0.031
  • Enrollee: means a natural person who has been voluntarily enrolled in a health care plan. See Nevada Revised Statutes 695C.030
  • Evidence of coverage: means any certificate, agreement or contract issued to an enrollee setting forth the coverage to which the enrollee is entitled. See Nevada Revised Statutes 695C.030
  • Health care plan: means any arrangement whereby any person undertakes to provide, arrange for, pay for or reimburse any part of the cost of any health care services and at least part of the arrangement consists of arranging for or the provision of health care services paid for by or on behalf of the enrollee on a periodic prepaid basis. See Nevada Revised Statutes 695C.030
  • Health care services: means any services included in the furnishing to any natural person of medical or dental care or hospitalization or incident to the furnishing of such care or hospitalization, as well as the furnishing to any person of any other services for the purpose of preventing, alleviating, curing or healing human illness or injury. See Nevada Revised Statutes 695C.030
  • 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
  • Oath: A promise to tell the truth.
  • physician: means a person who engages in the practice of medicine, including osteopathy and homeopathy. See Nevada Revised Statutes 0.040
  • 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
  • Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.