§ 695G.110 Medical director required to be physician licensed in this State
§ 695G.120 Utilization review: Development and maintenance of written policies and procedures for use by managed care organization and subcontractors
§ 695G.125 Contracts with certain federally qualified health centers
§ 695G.127 Contracts between managed care organization and provider of health care: Managed care organization required to use form to obtain information on provider of health care; modification; submission by managed care organization of schedule of payments
§ 695G.130 Report regarding methods for reviewing quality of health care services: Form of report; availability for public inspection
§ 695G.140 Certain persons in managed care organization in fiduciary relationship to insured
§ 695G.150 Authorization of recommended and covered health care services required
§ 695G.155 Managed care organization 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
§ 695G.160 Written criteria concerning coverage of health care services and standards for quality of health care services
§ 695G.162 Required provision concerning coverage for services provided through telehealth to same extent and in same amount as though provided in person or by other means; exception; prohibited acts. [Effective through May 19, 2023.]
§ 695G.162 v2 Required provision concerning coverage for services provided through telehealth to same extent and in same amount as though provided in person or by other means; exception; prohibited acts. [Effective May 20, 2023, through June 30, 2023.]
§ 695G.162 v3 Required provision concerning coverage for services provided through telehealth to same extent as though provided in person or by other means; prohibited acts. [Effective July 1, 2023.]
§ 695G.163 Plan covering prescription drugs: Provision of notice and information regarding use of formulary
§ 695G.1635 Plan covering prescription drugs: Required actions by managed care organization related to acquisition of prescription drugs for certain insureds residing in area for which emergency or disaster has been declared
§ 695G.164 Required provision in certain plans concerning coverage for continued medical treatment; exceptions; regulations
§ 695G.1645 Required provision in plan for group coverage concerning coverage for autism spectrum disorders for certain persons; prohibited acts
§ 695G.166 Plan covering prescription drugs prohibited from limiting or excluding coverage for prescription drug previously approved for medical condition of insured; exceptions
§ 695G.1665 Required provision in plan covering prescription drugs concerning coverage for prescription drugs irregularly dispensed for purpose of synchronization of chronic medications; prohibited acts; exception
§ 695G.167 Plan covering treatment of cancer through use of chemotherapy: Prohibited acts related to orally administered chemotherapy
§ 695G.1675 Plan covering prescription drug for treatment of cancer or cancer symptom that is part of step therapy protocol: Managed care organization required to allow insured or attending practitioner to apply for exemption from step therapy protocol in certa
§ 695G.168 Required provision in plan covering treatment of colorectal cancer concerning coverage for colorectal cancer screening
§ 695G.170 Required provision concerning coverage for medically necessary emergency services at any hospital; prohibited acts
§ 695G.1705 Required provision concerning coverage for drugs, laboratory testing and certain services related to human immunodeficiency virus; reimbursement of pharmacist for certain services
§ 695G.171 Required provision concerning coverage for certain tests and vaccines relating to human papillomavirus; prohibited acts
§ 695G.1712 Required provision concerning coverage for screening, genetic counseling and testing related to BRCA gene in certain circumstances
§ 695G.1713 Required provision concerning coverage for mammograms for certain women; prohibited acts
§ 695G.1714 Required provision concerning coverage for examination of person who is pregnant for certain diseases
§ 695G.1715 Required provision concerning coverage for drug or device for contraception and related health services; prohibited acts; exceptions
§ 695G.1716 Health care plan covering maternity care: Prohibited acts by managed care organization if insured is acting as gestational carrier; child deemed child of intended parent for purposes of plan
§ 695G.1717 Required provision concerning coverage for certain services, screenings and tests relating to wellness; prohibited acts
§ 695G.172 Plan covering prescription drugs: Denial of coverage prohibited for early refills of otherwise covered topical ophthalmic products
§ 695G.173 Required provision concerning coverage for certain treatment received as part of clinical trial or study for treatment of cancer or chronic fatigue syndrome; authority of managed care organization to require certain information; immunity from liab
§ 695G.174 Required provision concerning coverage for management and treatment of sickle cell disease and its variants; plan covering prescription drugs required to provide coverage for medically necessary prescription drugs to treat sickle cell disease and
§ 695G.175 Contracts for provision of emergency medical services, outpatient services or inpatient services with hospital or other facility that provides acute care in smaller city or county: Prohibited acts
§ 695G.176 Plan covering anatomical gifts, organ transplants or treatments or services related to organ transplants: Prohibited acts by managed care organization if insured is person with disability
§ 695G.177 Required provision in plans covering treatment of prostate cancer concerning coverage for prostate cancer screening; prohibited acts

Terms Used In Nevada Revised Statutes > Chapter 695G > Administration of Managed Care Organizations

  • Contract: A legal written agreement that becomes binding when signed.
  • 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
  • county: includes Carson City. See Nevada Revised Statutes 0.033
  • Dependent: A person dependent for support upon another.
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Fiduciary: A trustee, executor, or administrator.
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • person: means a natural person, any form of business or social organization and any other nongovernmental legal entity including, but not limited to, a corporation, partnership, association, trust or unincorporated organization. See Nevada Revised Statutes 0.039
  • physician: means a person who engages in the practice of medicine, including osteopathy and homeopathy. See Nevada Revised Statutes 0.040
  • population: means the number of people in a specified area as determined by the last preceding national decennial census conducted by the Bureau of the Census of the United States Department of Commerce pursuant to Section 2 of Article I of the Constitution of the United States and reported by the Secretary of Commerce to the Governor pursuant to 13 U. See Nevada Revised Statutes 0.050
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.