Each contract entered into for the purposes of a network plan between a participating provider of health care and the health carrier must include, without limitation, a provision which is substantially similar to the following:
Provider of health care agrees that in no event, including but not limited to, nonpayment by the health carrier or intermediary, insolvency of the health carrier or intermediary or breach of this agreement, shall the provider of health care bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against, a covered person or a person (other than the health carrier or intermediary) acting on behalf of the covered person for health care services provided pursuant to this agreement. This agreement does not prohibit the provider of health care from collecting coinsurance, deductibles or copayments, as specifically provided in the evidence of coverage, or fees for uncovered services delivered on a fee-for-service basis to covered persons. This agreement does not prohibit a provider of health care (except for a provider of health care who is employed full-time on the staff of the health carrier and has agreed to provide health care services exclusively to the health carrier’s covered persons and no others) and a covered person from agreeing to continue health care services solely at the expense of the covered person, as long as the provider of health care has clearly informed the covered person that the health carrier may not cover or continue to cover a specific health care service or health care services. Except as provided herein, this agreement does not prohibit the provider of health care from pursuing any available legal remedy.
(Added to NRS by 2017, 2350)
Structure Nevada Revised Statutes
Chapter 687B - Contracts of Insurance
NRS 687B.015 - "Binder" defined.
NRS 687B.030 - Waiver of payment of premium.
NRS 687B.040 - Insurable interest: Personal insurance.
NRS 687B.050 - Insurable interest: Exception when certain institutions designated beneficiary.
NRS 687B.060 - Insurable interest: Property.
NRS 687B.070 - Power to contract; purchase of insurance and annuities by minors.
NRS 687B.090 - Alteration of application: Life and health insurance.
NRS 687B.100 - Application as evidence.
NRS 687B.110 - Representations in applications.
NRS 687B.122 - Readability of policies: Applicability of requirements.
NRS 687B.128 - Readability of policies: Required approval by Commissioner in certain circumstances.
NRS 687B.130 - Grounds for disapproval or withdrawal of previous approval.
NRS 687B.140 - Standard provisions.
NRS 687B.160 - Execution of policies.
NRS 687B.170 - Underwriters’ and combination policies.
NRS 687B.180 - Validity and construction of noncomplying forms.
NRS 687B.182 - Binders: Issuance; period of effectiveness.
NRS 687B.183 - Binders: Forms; required statement related to certain policies; delivery of copies.
NRS 687B.185 - Binders: Prohibition of use to lower premiums.
NRS 687B.186 - Binders: Proof of insurance coverage; penalties for refusal to accept; exception.
NRS 687B.187 - Binders: Disapproval of insurer.
NRS 687B.200 - Assignability: Life or health insurance policy.
NRS 687B.220 - Forms for proof of loss required to be furnished by insurer to insured claimant.
NRS 687B.240 - Administration of claims not waiver.
NRS 687B.250 - Payment not to constitute admission of liability or waiver of defenses.
NRS 687B.255 - Insurer required to pay claim with negotiable instrument.
NRS 687B.260 - Exemption of proceeds of certain policies.
NRS 687B.270 - Exemption of proceeds: Health insurance.
NRS 687B.280 - Exemption of proceeds: Group insurance.
NRS 687B.290 - Exemption of proceeds: Annuities; assignability of rights.
NRS 687B.300 - Retention of proceeds of policy by insurer.
NRS 687B.310 - Cancellations and nonrenewals; scope of application.
NRS 687B.330 - Anniversary cancellation.
NRS 687B.345 - Annual review of coverage and benefits provided in policy.
NRS 687B.470 - "Health benefit plan" defined.
NRS 687B.500 - Basis for premium rate; exceptions.
NRS 687B.602 - "Administrator" defined.
NRS 687B.605 - "Covered person" defined.
NRS 687B.606 - "Dental care" defined.
NRS 687B.607 - "Direct notification" defined.
NRS 687B.610 - "Evidence of coverage" defined.
NRS 687B.615 - "Health benefit plan" defined.
NRS 687B.620 - "Health care services" defined.
NRS 687B.625 - "Health carrier" defined.
NRS 687B.630 - "Intermediary" defined.
NRS 687B.635 - "Medically necessary" defined.
NRS 687B.640 - "Network" defined.
NRS 687B.645 - "Network plan" defined.
NRS 687B.650 - "Participating provider of health care" defined.
NRS 687B.655 - "Primary care physician" defined.
NRS 687B.658 - "Provider network contract" defined.
NRS 687B.660 - "Provider of health care" defined.
NRS 687B.664 - "Third party" defined.
NRS 687B.665 - "Utilization review" defined.
NRS 687B.670 - Requirements to offer or issue network plan.
NRS 687B.675 - Provision of information to Office for Consumer Health Assistance.
NRS 687B.740 - Inducement to provide less than medically necessary health care services prohibited.
NRS 687B.760 - Health records; confidentiality.
NRS 687B.800 - Retaliation for good faith reporting to state or federal authority prohibited.
NRS 687B.820 - Procedures for resolution of disputes.
NRS 687B.862 - "Attachment point" defined.
NRS 687B.864 - "Group health plan" defined.
NRS 687B.866 - "Health care services" defined.
NRS 687B.868 - "Multiple employer welfare arrangement" defined.
NRS 687B.870 - "Network" defined.
NRS 687B.872 - "Policy of provider stop-loss insurance" defined.
NRS 687B.874 - "Policy of stop-loss insurance" defined.
NRS 687B.876 - "Provider of health care" defined.
NRS 687B.878 - Reporting of premiums written in this State for policies of stop-loss insurance.