If an all-payer claims database is established pursuant to NRS 439B.835:
1. Except as otherwise provided in this section, each health carrier, governing body of a local governmental agency that provides health insurance through a self-insurance reserve fund pursuant to NRS 287.010 or entity required by the regulations adopted pursuant to NRS 439B.875 to submit data to the database and the Public Employees’ Benefits Program shall submit to the all-payer claims database the data prescribed by the Department pursuant to NRS 439B.875 in the format prescribed by the Department pursuant to that section. The provisions of this subsection do not apply to:
(a) An issuer of insurance that only provides limited-scope dental or vision benefits or coverage that is only for a specified disease or illness, with respect to such coverage;
(b) An issuer of a Medicare supplemental policy, with respect to such a policy; or
(c) Any health carrier or other entity that provides health coverage to a total of less than 1,000 residents of this State.
2. A provider of health coverage for federal employees, a provider of health coverage that is subject to the Employee Retirement Income Security Act of 1974 or the administrator of a Taft-Hartley trust formed pursuant to 29 U.S.C. § 186(c)(5) are not required but may submit to the all-payer claims database the data prescribed by the Department pursuant to NRS 439B.875.
3. Before submitting data to the all-payer claims database pursuant to subsection 1 or 2, an entity described in either of those subsections shall:
(a) Remove all direct patient identifiers from the data; and
(b) Assign a unique identifier to all data concerning a specific patient.
4. As used in this section:
(a) "Health carrier" means an entity subject to the insurance laws and regulations of this State, or subject to the jurisdiction of the Commissioner of Insurance, that contracts or offers to contract to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services, including, without limitation, a sickness and accident health insurance company, a health maintenance organization, a nonprofit hospital and health service corporation or any other entity providing a plan of health insurance, health benefits or health care services.
(b) "Medicare supplemental policy" has the meaning ascribed to it in 42 C.F.R. § 403.205 and additionally includes policies offered by public entities that otherwise meet the requirements of that section.
(Added to NRS by 2021, 3052, effective January 1, 2022)
Structure Nevada Revised Statutes
Chapter 439B - Restraining Costs of Health Care
NRS 439B.030 - "Billed charge" defined.
NRS 439B.035 - "Children’s Health Insurance Program" defined.
NRS 439B.040 - "Committee" defined.
NRS 439B.050 - "Department" defined.
NRS 439B.060 - "Director" defined.
NRS 439B.070 - "Discharge form" defined.
NRS 439B.090 - "Fiscal year" defined.
NRS 439B.100 - "Health facility" defined.
NRS 439B.110 - "Hospital" defined.
NRS 439B.115 - "Major hospital" defined.
NRS 439B.120 - "Medicaid" defined.
NRS 439B.130 - "Medicare" defined.
NRS 439B.140 - "Net revenue" defined.
NRS 439B.150 - "Practitioner" defined.
NRS 439B.160 - Purposes of chapter.
NRS 439B.210 - Meetings; quorum; compensation.
NRS 439B.270 - Foundation for hospital nursing practice: Establishment; governing body.
NRS 439B.275 - Program for provision of technical assistance to rural hospitals.
NRS 439B.300 - Legislative findings and declarations; applicability.
NRS 439B.310 - "Indigent" defined.
NRS 439B.350 - Department to establish; purpose.
NRS 439B.360 - Evaluation: Recommendations; report to Interim Finance Committee.
NRS 439B.370 - Director authorized to contract for certain services.
NRS 439B.400 - Hospital must maintain and use uniform list of billed charges; exception.
NRS 439B.425 - Prohibited referral of patients; exceptions; penalty.
NRS 439B.450 - Powers and duties of Director.
NRS 439B.460 - Director authorized to delegate powers and duties.
NRS 439B.500 - Penalty for violation of provisions.
NRS 439B.605 - "Manufacturer" defined.
NRS 439B.607 - "National Drug Code" defined.
NRS 439B.610 - "Pharmacy" defined.
NRS 439B.615 - "Pharmacy benefit manager" defined.
NRS 439B.616 - "Rebate" defined.
NRS 439B.618 - "Third party" defined.
NRS 439B.619 - "Unit" defined.
NRS 439B.620 - "Wholesale acquisition cost" defined.
NRS 439B.622 - "Wholesaler" defined.
NRS 439B.630 - Department to annually compile lists of certain prescription drugs.
NRS 439B.675 - Manner of presentation of information.
NRS 439B.680 - Immunity from civil and criminal liability.
NRS 439B.703 - "Covered person" defined.
NRS 439B.706 - "Independent center for emergency medical care" defined.
NRS 439B.709 - "In-network emergency facility" defined.
NRS 439B.712 - "In-network provider" defined.
NRS 439B.715 - "Medically necessary emergency services" defined.
NRS 439B.718 - "Out-of-network emergency facility" defined.
NRS 439B.721 - "Out-of-network provider" defined.
NRS 439B.724 - "Provider contract" defined.
NRS 439B.727 - "Provider of health care" defined.
NRS 439B.730 - "Prudent person" defined.
NRS 439B.733 - "Screen" defined.
NRS 439B.739 - "To stabilize" and "stabilized" defined.
NRS 439B.742 - Inapplicability of provisions to certain hospitals, persons and health care services.
NRS 439B.748 - Payment to out-of-network emergency facility by third party.
NRS 439B.751 - Payment to out-of-network provider, other than emergency facility, by third party.
NRS 439B.760 - Reports; confidentiality of information.
NRS 439B.800 - Definitions. [Effective January 1, 2022.]
NRS 439B.805 - "All-payer claims database" defined. [Effective January 1, 2022.]
NRS 439B.810 - "Covered entity" defined. [Effective January 1, 2022.]
NRS 439B.815 - "Direct patient identifier" defined. [Effective January 1, 2022.]
NRS 439B.820 - "Proprietary financial information" defined. [Effective January 1, 2022.]
NRS 439B.825 - "Provider of health care" defined. [Effective January 1, 2022.]
NRS 439B.830 - "Unique identifier" defined. [Effective January 1, 2022.]
NRS 439B.850 - Data requests. [Effective January 1, 2022.]
NRS 439B.870 - Immunity from certain civil or criminal liability. [Effective January 1, 2022.]