1. The Commissioner shall:
(a) Develop, prescribe and make available on an Internet website maintained by the Division a form letter that a health carrier must use to notify a provider of health care of the denial of his or her application to be included in the network of providers of the health carrier. The form letter must include, without limitation, a place for the health carrier to explain the reason for the denial of the application.
(b) Hold hearings to solicit public input when developing the form letter described in paragraph (a) and consider such input when developing the form letter.
2. A health carrier shall submit to the Commissioner a copy of each form letter sent to a provider of health care pursuant to subsection 1. The Commissioner shall determine the frequency with which such form letters must be submitted by the health carrier to the Commissioner. Except as otherwise provided in subsection 3, the forms submitted to the Commissioner pursuant to this subsection and the information contained therein are confidential.
3. The Commissioner shall:
(a) Annually compile a report using aggregated data from the forms collected pursuant to subsection 2 concerning trends in the denial of applications of providers of health care to be included in the network of providers of a health carrier. The report must include, without limitation, the number of total denials, the number of denials for different types of providers of health care, the number of denials by different carriers and the reasons for such denials.
(b) Post the report on an Internet website maintained by the Division.
(c) Submit the report to the Governor and the Director of the Legislative Counsel Bureau for transmittal to the Legislature.
4. As used in this section, "health carrier" means an entity subject to the insurance laws and regulations of this State, or subject to the jurisdiction of the Commissioner, 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.
(Added to NRS by 2019, 551; A 2021, 2943)
Structure Nevada Revised Statutes
Chapter 679B - Commissioner of Insurance
NRS 679B.030 - Qualifications.
NRS 679B.100 - Prohibited interests of Commissioner, deputy or employee; penalty.
NRS 679B.110 - Delegation of powers.
NRS 679B.120 - General powers and duties of Commissioner.
NRS 679B.125 - Observation of conduct of persons in insurance business; regulations.
NRS 679B.137 - Regulations: Method and period for maintaining records of insurers.
NRS 679B.140 - Orders and notices: Effectivity; contents of orders; methods of provision.
NRS 679B.159 - Report of violation to Commissioner; confidentiality of report.
NRS 679B.160 - Advisory councils and committees.
NRS 679B.170 - Private ombudsmen.
NRS 679B.180 - Enforcement; Attorney General to act as legal counsel; exception.
NRS 679B.220 - Interstate and international cooperation.
NRS 679B.225 - Inspection of insurance policies.
NRS 679B.227 - Statute of limitations for commencing proceedings to collect premium tax.
NRS 679B.228 - Fee for returned check or other dishonored payment.
NRS 679B.230 - Examination of insurers.
NRS 679B.250 - Conduct of examination; access to records; corrections; penalty.
NRS 679B.260 - Appraisal of asset.
NRS 679B.270 - Report of examination: Filing; contents; evidentiary effect in certain proceedings.
NRS 679B.285 - Report of examination: Disclosure; confidentiality.
NRS 679B.290 - Expense of examination; billing for examination; regulations.
NRS 679B.300 - Deposit of money; payment of certain expenses.
NRS 679B.310 - Administrative procedures; hearings in general.
NRS 679B.320 - Notice of hearing.
NRS 679B.330 - Location; presiding officer; evidence; parties; record of proceedings and evidence.
NRS 679B.340 - Witnesses and evidence; penalties.
NRS 679B.350 - Testimony compelled; immunity from prosecution.
NRS 679B.360 - Order on hearing.
NRS 679B.370 - Appeal from Commissioner.
NRS 679B.380 - Financing of administration and enforcement; claims.
NRS 679B.400 - Legislative findings and declarations; purposes.
NRS 679B.410 - Duties of Commissioner.
NRS 679B.420 - Employment of technical and professional consultants.
NRS 679B.440 - Contents of reports.
NRS 679B.460 - Penalties for violation of or noncompliance with provisions or regulations.
NRS 679B.520 - "Health care plan" defined.
NRS 679B.530 - "Insured" defined.
NRS 679B.540 - "Insurer" defined.
NRS 679B.550 - Duties of Division.
NRS 679B.560 - Insurer required to provide information to insured.
NRS 679B.610 - "Fraud Control Unit" defined.
NRS 679B.620 - "Insurance fraud" defined.
NRS 679B.630 - Program to investigate acts or practices of fraud.
NRS 679B.640 - Commissioner required to investigate fraudulent claims for benefits.